2 0 1 0 C L A Y C A M P R E G I S T R A T I O N F O R M

To register: Print out, fill out, and send in this form to:
Clayworks Studio / 4130 Greenbush Ave / Sherman Oaks, CA, 91423
Session dates and prices can be found on the information page.
Student's Name:
School:
Age:
Gender:
Home Address:
City:
Zip:
Mother's Name:

Email:
(Required)
Phone: Home
Work
Father's Name:
Phone: Home
Work
Emergency Contact:
Telephone:
Relationship:
Financially Responsible Party:
Billing Address:
City:
Zip:
Physician Name:
Phone:
Please enroll my child in the following sessions:
Teen Workshops
Fridays
(10:00am - 1:00pm)

 Workshop are $70 each! Circle one or more.
June 25, July 2, 9, 16, 23, 30 Aug 6, 13, 20
Ages: 6 to 10
Morning Class:
(9:30am -12:30pm)

Mon. thru Thurs
Tuition for two
week session:
Ages: 11 to 14
Afternoon Class:
(1:30pm - 4:30pm)

Mon. thru Thurs
Tuition for two
week session:
Sessions*:
Course #
Rate
Course #
Rate
June 14th - June 24th
#1
$480
#2
$480
June 28th - July 8th
#3
$480
#4
$480
July 12th - July 22nd
#5
$480
#6
$480
July 26th - August 5th
#7
$480
#8
$480
August 9th - August 19th
#9
$480
#10
$480
*Pay with cash and take $25 off!
Total $ Enclosed:
Please make check payable to:
 Clayworks Studio,
4130 Greenbush Ave.,
Sherman Oaks, CA 91423