Application Received On:

Confirmation -

Send:

Sent:

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ENROLLMENT APPLICATION
VALLEY VILLAGE CAMPUS
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STEP 1: PARENT INFORMATION
To begin, type in all necessary family information. A working Email
address is required as most camp communications are sent this way.
(This is NOT the K CAMP application)
_______________________________________________________________________

Are you a new, friend or returning family?

New Returning Friend

I am attending:

Session 1 Session 2 Session 1 & 2

Days I will be attending:

2 Days per Week 3 Days per Week 5 Days per Week

Enroll me with friends:

Yes No

MOM
First Name		Last Name
Address		City
State		Zip
Home Phone		Work Phone
Cell Phone		Email

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DAD or SECOND GUARDIAN
First Name		Last Name
Address		City
State		Zip
Home Phone		Work Phone
Cell Phone		Email

_______________________________________________________________________

Emergency Contact(s)

Phone Number

Family Doctor

Phone Number

Authorized person(s) to pick up my child(ren)

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STEP 2: HOW DID YOU HEAR ABOUT US?
In an effort to better target our marketing campaigns, please let
us know where you first heard about our program.
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LA Parent		Friend		Flyer		Car Flyer
Banner		Internet		Postcard		At School
Other

STEP 3: YOUR FIRST CHILD'S INFORMATION
Complete all fields below for the first child you are enrolling
______________________________________________________________________

First Name		Last Name
Sex	Female Male	Age in June
School		Current Grade

If you can, enroll me with my friends
I am attending camp alone

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STEP 4: YOUR SECOND CHILD'S INFORMATION
Complete all fields below for the second child you are enrolling
______________________________________________________________________

First Name		Last Name
Sex	Female Male	Age in June
School		Current Grade

If you can, enroll me with my friends
I am attending camp alone

______________________________________________________________________

STEP 5: WORKSHOP CHOICES FOR YOUR FIRST CHILD
You are now ready to select your first child's workshops. Please rememeber to
check daily workshop schedules BEFORE making your choices as some workshops
may already be closed. You and your child should select two choices of workshops
within each of the four time periods as your first choice may close between
the time you complete your application and the time we receive it.
If so, we will automatically enter your child into their second choice.

Session One:M/W/F Check Workshop Status Click Here!
Time	1st Choice	2nd Choice
9:00 - 10:10	1 WOODWORKING 2 BLAST OFF BREAKFAST! 3 CARTOONING: SUPERHEROS 4 LET'S DANCE! 5 ELECTRONIC STORYBOOK 6 ART-O-RAMA 7 ART IN THE GARDEN 8 CERAMICS 9 CHECKMATE 10 ACRYLIC PAINTING 11 CAPOERIA 12 MAGIC AND MORE MAGIC!	1 WOODWORKING 2 BLAST OFF BREAKFAST! 3 CARTOONING: SUPERHEROS 4 LET'S DANCE! 5 ELECTRONIC STORYBOOK 6 ART-O-RAMA 7 ART IN THE GARDEN 8 CERAMICS 9 CHECKMATE 10 ACRYLIC PAINTING 11 CAPOERIA 12 MAGIC AND MORE MAGIC!
10:35 - 11:45	13 WOODWORKING 14 ITALIAN CUISINE 15 ANIME' & MANGA 16 THEATRE: SHREK 17 ELECTRONIC ARTS 18 MOSAIC CREATIONS 19 THE BIG CHEESE PRESS 20 CREATIONS IN CLAY 21 WATERCOLORS 22 LEGO ROBOTICS 23 CAPOERIA 24 CARD TRICKS & MAGIC	13 WOODWORKING 14 ITALIAN CUISINE 15 ANIME' & MANGA 16 THEATRE: SHREK 17 ELECTRONIC ARTS 18 MOSAIC CREATIONS 19 THE BIG CHEESE PRESS 20 CREATIONS IN CLAY 21 WATERCOLORS 22 LEGO ROBOTICS 23 CAPOERIA 24 CARD TRICKS & MAGIC
12:45 - 1:55	25 WOODWORKING 26 PAPER SCULPTURE 27 HIGH SCHOOL MUSICAL 2 28 YOGA WORKS 29 LEGO ROBOTICS 30 PASTEL TECHNIQUES 31 MIX MASTERS II 32 FENCING 33 COMIC BOOK WORKSHOP 34 MUMMIES OF EGYPT 35 SHUTTERBUGS 36 SECRET AGENT TRAINING	25 WOODWORKING 26 PAPER SCULPTURE 27 HIGH SCHOOL MUSICAL 2 28 YOGA WORKS 29 LEGO ROBOTICS 30 PASTEL TECHNIQUES 31 MIX MASTERS II 32 FENCING 33 COMIC BOOK WORKSHOP 34 MUMMIES OF EGYPT 35 SHUTTERBUGS 36 SECRET AGENT TRAINING
2:20 - 3:30	37 WOODWORKING 38 FINGER FOODS 39 SCULPTURE STUDIO 40 HANNAH MONTANA LIVE! 41 YOGA WORKS 42 LEGO ROBOTICS 43 ANIMAL DRAWING 44 COMPUTER COLLAGE 45 FENCING 46 FUNNY CHARACTERS 47 NATIVE AMERICAN ARTS 48 PORTRAIT PHOTOGRAPHY	37 WOODWORKING 38 FINGER FOODS 39 SCULPTURE STUDIO 40 HANNAH MONTANA LIVE! 41 YOGA WORKS 42 LEGO ROBOTICS 43 ANIMAL DRAWING 44 COMPUTER COLLAGE 45 FENCING 46 FUNNY CHARACTERS 47 NATIVE AMERICAN ARTS 48 PORTRAIT PHOTOGRAPHY

Session One:T/TH Check Workshop Status Click Here!
Time	1st Choice	2nd Choice
9:00 - 10:10	49 WOODWORKING 50 BLAST OFF BREAKFAST! 51 SCI-FI ALIENS 52 CHORUS LINE 53 GRAFITTI TECH 54 ART IN MOTION 55 ART PHOTOGRAPHY 56 CREATIONS IN CLAY 57 MUSIC OF RAINFORESTS 58 QUILTING 59 WATERCOLORS 60 PILATES 4 KIDS 61 TREASURE PIRATES	49 WOODWORKING 50 BLAST OFF BREAKFAST! 51 SCI-FI ALIENS 52 CHORUS LINE 53 GRAFITTI TECH 54 ART IN MOTION 55 ART PHOTOGRAPHY 56 CREATIONS IN CLAY 57 MUSIC OF RAINFORESTS 58 QUILTING 59 WATERCOLORS 60 PILATES 4 KIDS 61 TREASURE PIRATES
10:35 - 11:45	62 WOODWORKING 63 TV CHEFS 64 CARTOONING: MONSTERS 65 MYSTERY RADIO THEATRE 66 FLASH! 67 BEAD MANIA 68 CERAMICS 69 AFRICAN HAND DRUMMING 70 SEWING: FOCUS CLOTHING 71 ACRYLIC PAINTING 72 PILATES 4 KIDS 73 TREASURE PIRATES	62 WOODWORKING 63 TV CHEFS 64 CARTOONING: MONSTERS 65 MYSTERY RADIO THEATRE 66 FLASH! 67 BEAD MANIA 68 CERAMICS 69 AFRICAN HAND DRUMMING 70 SEWING: FOCUS CLOTHING 71 ACRYLIC PAINTING 72 PILATES 4 KIDS 73 TREASURE PIRATES
12:45 - 1:55	74 WOODWORKING 75 SPY CHEFS 76 VOICE ACADEMY 77 DIGITAL ORIGAMI 78 MASKS AROUND WORLD 79 MUMMIES OF EGYPT 80 PASTEL TECHNIQUES 81 FUN WITH FLUTES 82 FASHION DESIGN 83 LEGO ROBOTICS 84 CHEER SQUAD 85 SECRET AGENT TRAINING	74 WOODWORKING 75 SPY CHEFS 76 VOICE ACADEMY 77 DIGITAL ORIGAMI 78 MASKS AROUND WORLD 79 MUMMIES OF EGYPT 80 PASTEL TECHNIQUES 81 FUN WITH FLUTES 82 FASHION DESIGN 83 LEGO ROBOTICS 84 CHEER SQUAD 85 SECRET AGENT TRAINING
2:20 - 3:30	86 WOODWORKING 87 MASTERPIECE COOKIES 88 ROBOTS & SPACESHIPS 89 HANNAH MONTANA LIVE! 90 MIX MASTERS I 91 MONSTERS AND WIZARDS 92 ART OF MEXICO 93 ANIMAL DRAWING 94 WORLD OF DRUMMING 95 AFRICAN EMBROIDERY 96 LEGO ROBOTICS 97 CHEER SQUAD	86 WOODWORKING 87 MASTERPIECE COOKIES 88 ROBOTS & SPACESHIPS 89 HANNAH MONTANA LIVE! 90 MIX MASTERS I 91 MONSTERS AND WIZARDS 92 ART OF MEXICO 93 ANIMAL DRAWING 94 WORLD OF DRUMMING 95 AFRICAN EMBROIDERY 96 LEGO ROBOTICS 97 CHEER SQUAD

Session Two:M/W/F Check Workshop Status Click Here!
Time	1st Choice	2nd Choice
9:00 - 10:10	98 WOODWORKING 99 BLAST OFF BREAKFAST! 100 CARTOONING: SCI-FI ALIENS 101 LET'S DANCE! 102 ELECTRONIC ARTS 103 ART-O-RAMA 104 ART PHOTOGRAPHY 105 CREATIONS IN CLAY 106 BEGINNING CHESS 107 SEWING: FOCUS QUILTING 108 CAPOERIA 109 CARD TRICKS & MAGIC	98 WOODWORKING 99 BLAST OFF BREAKFAST! 100 CARTOONING: SCI-FI ALIENS 101 LET'S DANCE! 102 ELECTRONIC ARTS 103 ART-O-RAMA 104 ART PHOTOGRAPHY 105 CREATIONS IN CLAY 106 BEGINNING CHESS 107 SEWING: FOCUS QUILTING 108 CAPOERIA 109 CARD TRICKS & MAGIC
10:35 - 11:45	110 WOODWORKING 111 ITALIAN CUISINE 112 CARTOONING: MONSTERS 113 THEATRE: SHREK 114 ELECTRONIC STORYBOOK 115 MOSAIC CREATIONS 116 THE BIG CHEESE PRESS 117 CERAMICS 118 CHECKMATE 119 FASHION DESIGN 120 LEGO ROBOTICS 121 MAGIC AND MORE MAGIC!	110 WOODWORKING 111 ITALIAN CUISINE 112 CARTOONING: MONSTERS 113 THEATRE: SHREK 114 ELECTRONIC STORYBOOK 115 MOSAIC CREATIONS 116 THE BIG CHEESE PRESS 117 CERAMICS 118 CHECKMATE 119 FASHION DESIGN 120 LEGO ROBOTICS 121 MAGIC AND MORE MAGIC!
12:45 - 1:55	122 WOODWORKING 123 FINGER FOODS 124 PAPER SCULPTURE 125 HIGH SCHOOL MUSICAL 2 126 YOGA WORKS 127 LEGO ROBOTICS 128 PASTEL TECHNIQUES 129 ELECTRONIC ARTS 130 COMIC BOOK WORKSHOP 131 MUMMIES OF EGYPT 132 AFRICAN EMBROIDERY 133 SECRET AGENT TRAINING	122 WOODWORKING 123 FINGER FOODS 124 PAPER SCULPTURE 125 HIGH SCHOOL MUSICAL 2 126 YOGA WORKS 127 LEGO ROBOTICS 128 PASTEL TECHNIQUES 129 ELECTRONIC ARTS 130 COMIC BOOK WORKSHOP 131 MUMMIES OF EGYPT 132 AFRICAN EMBROIDERY 133 SECRET AGENT TRAINING
2:20 - 3:30	134 WOODWORKING 135 ASIAN CUISINE 136 SCULPTURE STUDIO 137 HANNAH MONTANA LIVE! 138 YOGA WORKS 139 LEGO ROBOTICS 140 ACRYLIC PAINTING 141 COMPUTER COLLAGE 142 FENCING 143 ROBOTS & SPACESHIPS 144 NATIVE AMERICAN ARTS 145 THE ART OF PAPER	134 WOODWORKING 135 ASIAN CUISINE 136 SCULPTURE STUDIO 137 HANNAH MONTANA LIVE! 138 YOGA WORKS 139 LEGO ROBOTICS 140 ACRYLIC PAINTING 141 COMPUTER COLLAGE 142 FENCING 143 ROBOTS & SPACESHIPS 144 NATIVE AMERICAN ARTS 145 THE ART OF PAPER

Session Two:T/TH Check Workshop Status Click Here!
Time	1st Choice	2nd Choice
9:00 - 10:10	146 WOODWORKING 147 BLAST OFF BREAKFAST! 148 CARTOONING: SUPERHEROS 149 CHORUS LINE 150 GRAFITTI TECH 151 MASKS AROUND THE WORLD 152 ART IN THE GARDEN 153 CERAMICS 154 MUSIC OF RAINFORESTS 155 ANIMAL DRAWING 156 WATERCOLORS 157 PILATES 4 KIDS 158 TREASURE PIRATES	146 WOODWORKING 147 BLAST OFF BREAKFAST! 148 CARTOONING: SUPERHEROS 149 CHORUS LINE 150 GRAFITTI TECH 151 MASKS AROUND THE WORLD 152 ART IN THE GARDEN 153 CERAMICS 154 MUSIC OF RAINFORESTS 155 ANIMAL DRAWING 156 WATERCOLORS 157 PILATES 4 KIDS 158 TREASURE PIRATES
10:35 - 11:45	159 WOODWORKING 160 TV CHEFS 161 ANIME' & MANGA 162 MYSTERY RADIO THEATRE 163 FLASH! 164 BEAD MANIA 165 CREATIONS IN CLAY 166 AFRICAN HAND DRUMMING 167 PASTEL TECHNIQUES 168 ACRYLIC PAINTING 169 PILATES 4 KIDS 170 TREASURE PIRATES	159 WOODWORKING 160 TV CHEFS 161 ANIME' & MANGA 162 MYSTERY RADIO THEATRE 163 FLASH! 164 BEAD MANIA 165 CREATIONS IN CLAY 166 AFRICAN HAND DRUMMING 167 PASTEL TECHNIQUES 168 ACRYLIC PAINTING 169 PILATES 4 KIDS 170 TREASURE PIRATES
12:45 - 1:55	171 WOODWORKING 172 COMIC BOOK WORKSHOP 173 VOICE ACADEMY 174 DIGITAL ORIGAMI 175 ART IN MOTION 176 MUMMIES OF EGYPT 177 WATERCOLORS 178 FUN WITH FLUTES 179 SHUTTERBUGS 180 LEGO ROBOTICS 181 CHEER SQUAD 182 SECRET AGENT TRAINING	171 WOODWORKING 172 COMIC BOOK WORKSHOP 173 VOICE ACADEMY 174 DIGITAL ORIGAMI 175 ART IN MOTION 176 MUMMIES OF EGYPT 177 WATERCOLORS 178 FUN WITH FLUTES 179 SHUTTERBUGS 180 LEGO ROBOTICS 181 CHEER SQUAD 182 SECRET AGENT TRAINING
2:20 - 3:30	183 WOODWORKING 184 MASTERPIECE COOKIES 185 FUNNY CHARACTERS 186 HANNAH MONTANA LIVE! 187 WEB DESIGN 188 MONSTERS AND WIZARDS 189 ART OF MEXICO 190 ACRYLIC PAINTING 191 WORLD OF DRUMMING 192 PORTRAIT PHOTOGRAPHY 193 LEGO ROBOTICS 194 CHEER SQUAD	183 WOODWORKING 184 MASTERPIECE COOKIES 185 FUNNY CHARACTERS 186 HANNAH MONTANA LIVE! 187 WEB DESIGN 188 MONSTERS AND WIZARDS 189 ART OF MEXICO 190 ACRYLIC PAINTING 191 WORLD OF DRUMMING 192 PORTRAIT PHOTOGRAPHY 193 LEGO ROBOTICS 194 CHEER SQUAD

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STEP 7: TUITION CALCULATION
Please select all the sessions you are enrolling in. Decide if you will
need extended care, which is billed at $7 per hour if you sign up in
advance, or if you want your children to have a camp T-Shirt.

MY FIRST CHILD....

IS ENROLLING IN

(enter your child's name above)

Session One 5 Days a Week - $1216 Session One 5 Days a Week - with Extended Care -$1548.5 Session One M/W/F - $704 Session One M/W/F -with Extended Care - $896.5 Session One T/TH - $512 Session One T/TH - with Extended Care-$652 Session Two 5 Days a Week - $1280 Session Two 5 Days a Week -with extended care- $1630 Session Two M/W/F - $768 Session Two M/W/F -with Extended Care - $978 Session Two T/TH - $512 Session Two T/TH - with Extended Care-$652

and Session Two 5 Days a Week - $1280 Session Two 5 Days a Week -with extended care- $1630 Session Two M/W/F - $768 Session Two M/W/F -with Extended Care - $978 Session Two T/TH - $512 Session Two T/TH - with Extended Care-$652

Camp Merchandise, double click name to see item

do you want a camp shirt? 1 Small - $13 2 Small - $26 1 Medium - $13 2 Medium - $26 1 Large - $13 2 Large - $26

do you want a lunch box and water bottle? 1 - $20

do you want a camp hat? 1 Olive Green - $15 1 Ceramic Blue Trim - $15 1 Navy Blue Trim - $15 1 Orange Trim - $15

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MY SECOND CHILD....

IS ENROLLING IN

(enter your child's name above)

Session One 5 Days a Week - $1216 Session One 5 Days a Week - with Extended Care -$1548.5 Session One M/W/F - $704 Session One M/W/F -with Extended Care - $896.5 Session One T/TH - $512 Session One T/TH - with Extended Care-$652 Session Two 5 Days a Week - $1280 Session Two 5 Days a Week -with extended care- $1630 Session Two M/W/F - $768 Session Two M/W/F -with Extended Care - $978 Session Two T/TH - $512 Session Two T/TH - with Extended Care-$652

and Session Two 5 Days a Week - $1280 Session Two 5 Days a Week -with extended care- $1630 Session Two M/W/F - $768 Session Two M/W/F -with Extended Care - $978 Session Two T/TH - $512 Session Two T/TH - with Extended Care-$652

Camp Merchandise, double click name to see item

do you want a camp shirt? 1 Small - $13 2 Small - $26 1 Medium - $13 2 Medium - $26 1 Large - $13 2 Large - $26

do you want a lunch box and water bottle? 1 - $20

do you want a camp hat? 1 Olive Green - $15 1 Ceramic Blue Trim - $15 1 Navy Blue Trim - $15 1 Orange Trim - $15

If your second child is attending the same session(s)
as your first child is, you are entitled to a 5% discount.
Select that now. Does NOT apply to extended care fees.

Session One Discount - Select Here 5% Discount on Session One M/W/F of - $35.20 5% Discount on Session One T/TH of - $25.60 5% Discount on Session One M to F of - $60.80

Session Two Discount - Select Here 5% Discount on Session Two M/W/F of - $38.40 5% Discount on Session Two T/TH of - $25.60 5% Discount on Session Two M to F of - $64.00

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Now add up all amounts selected and enter your
total tuition payment where indicated below.
Use a calculator, total tuition is not automatically entered.

MY TOTAL TUITION IS...

Please Note:
Material fees, if any, will be billed when we process your application.
If you will be paying by credit card, material fees,
if any, will be charged at that time.
If paying by check, we will bill you for any outstanding material fees due.
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STEP 8: PAYMENT METHOD
How would you like to pay for camp tuition?
If you pay by check, just mail the total tuition (above)
in with your completed application.
If you elect to pay by credit card an additional 3%
will be added to total tuition fees.
We do not accept American Express.
Make Checks Payable to: The Summer Art Academy

Card Type	Visa MasterCard
Cardholder Name
Account Number
Expiration Date

CARDHOLDER SIGNATURE: __________________________________________
(Sign above after you have printed out your completed application)
____________________________________________________________________

STEP 9: TERMS AND CONDITIONS
Please read our terms and conditions, registration cannot be
completed without signing and clicking the accept box below

1. ENROLLMENT: Children will be enrolled in workshops on a first-come, first-served basis. Enrollment above or below the recommended grade level will be considered in special cases. 2. MEDICAL INFORMATION: Your child's health is important to us. Your medical form must be on file with us prior to your child's first day of camp. Please advise us in advance of any special medical needs your child may have. Campers must be in good health: Allergies and other conditions, which might affect the health, safety or welfare of the camper, must be noted on the health history form provided. The Art Camp provides student accident protection for campers. Parents insurance is primary.By signing and accepting below, you allow the Art Camp to select a physician should your child be confronted with a medical emergency and you cannot be reached. 3. ABSENCES: There are no makeup days for absences or for days missed and parents are financially responsible for all days that their child has registered to attend. There will be no prorating of tuition for missed workshops due to sickness or travel, or any other reason. 4. TUITION: Full tuition must accompany each application in order for your child to be registered for workshops. A 5% discount is offered for a additional siblings enrolled in the same session from the same immediate family. All discounts apply to the session fee only and not to any workshop material fees. A 3% finance charge will be added when using a credit card. There is a $10 fee on all returned checks. 5. WORKSHOP CHANGES: Workshop changes will be made on a space available basis at the directors or assistant directors discretion. Changes will be considered during the first week of camp only, no exceptions. A $10 fee per workshop is due at the time the change is made. 6. WORKSHOP CANCELLATIONS: We reserve the right to limit class size, substitute instructors or cancel workshops for which there are not enough children enrolled. Every effort will be made to place your child in their second choice or into a similar workshop offered. 7. WITHDRAWALS AND REFUNDS: We do not offer refunds for camper's time off, missed days, family vacation, partially missed days, any medical reasons or anything else that requires time off from camp. Should you withdraw from the summer program prior to June 3rd 2008, you will receive a full refund minus a $100 cancellation fee PER child PER session enrolled. After June 3rd, 2008 there will be NO refunds - NO exceptions. If your child is dismissed from our summer program for disciplinary measures, you will receive a refund equal to 50% of unused tuition for the time remaining. While the Art Camp strives to make Camp enjoyable for all campers, satisfaction with the experience is subjective on the part of the child and the parent. Therefore, it is understood and agreed that the Art Camp cannot and does not guarantee or warrant any campers' satisfaction. It is also understood and agreed that there are no other agreements, expressed or implied, between the Art Camp and me or my child regarding the Art Camps programs or activities. 8. YOU FURTHER AGREE: A. To pay for any material fees for those workshops that have fees associated with them. Allow you child's image to be used in any and all promotional photographs, videos or websites and print ads. B. To not hold the Art Camp responsible for any articles of clothing or personal belongings that are lost or damaged by theft, fire, natural disaster or other occurrence.

I ACCEPT:

DATE: ______________

PARENT/GUARDIAN SIGNATURE: ______________________________________
(Sign above after you have printed out your completed application,
By signing above you accept all our terms and conditions.)
____________________________________________________________________

STEP 10: MEDICAL INFORMATION FORM
Please click below to open up the camp medical form.
When complete, print this out and mail with your applciation.
Your child will not be enrolled in workshops
without a completed medical form!
MEDICAL FORM
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STEP 11: ORDER A FRESH LUNCH FOR YOUR KIDS
Please click the Fresh Lunches bar below to register for camp lunches and snacks.
If you have signed up for extended care make sure you order an after camp snack!

____________________________________________________________________

THAT'S IT! NOW PRINT OUT YOUR COMPLETED
APPLICATION AND SIGN WHERE REQUIRED.
Along with your completed and signed medical form, mail it in with your tuition check to:
4130 Greenbush Ave. Sherman Oaks, CA. 91423.
All applications must be MAILED in and are processed in the order which they are received.
NOW JUST WATCH FOR YOUR CONFIRMATION OF ENROLLMENT BY EMAIL
SEE YOU AT CAMP!