Application Received On:
Confirmation -
Send:
 Sent:

_______________________________________________________________________
ENROLLMENT APPLICATION
AGOURA HILLS CAMPUS
_______________________________________________________________________

STEP 1: PARENT INFORMATION
To begin, complete all necessary family information. A working Email
address is required as most camp communications are sent this way.
_______________________________________________________________________
Are you a new or returning family?
I am attending:
Days I will be attending:
Enroll me with my friends:

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

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)

_______________________________________________________________________

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.
______________________________________________________________________
LA Parent
Friend
Flyer
The Acorn
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
Age in June
School
Current Grade

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

STEP 4: YOUR SECOND CHILD'S INFORMATION
Complete all fields below for the second child you are enrolling
______________________________________________________________________
First Name
Last Name
Sex
Age in June
School
Current Grade

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

______________________________________________________________________

STEP 5: TUITION CALCULATION AND GROUP SELECTION
Please select all the session(s) and group (s) you are enrolling in. Decide if
you will need extended care, which is billed at $7 per hour if you sign up in
advance. One camp T-Shirt and all materials are included in your tuition.
This shirt must be worn daily.
Then add up all amounts selected and enter your
total tuition payment where indicated below.
MY FIRST CHILD....
IS ENROLLING IN
(enter your child's name above)
______________________________________________________________________
Select your session(s) from the pull down menu's below
and
Child Shirt Size?
Camp Merchandise, double click name to see item
do you want a lunch box and water bottle?
do you want a camp hat?
______________________________________________________________________

MY SECOND CHILD....
IS ENROLLING IN
(enter your child's name above)
______________________________________________________________________
Select your session(s) from the pull down menu's below
and
Child Shirt Size?
Camp Merchandise, double click name to see item
do you want a lunch box and water bottle?
do you want a camp hat?
______________________________________________________________________

If your second K Camper is attending
the same session(s) as your first K Camper is,
you are entitled to a 5% discount. Select that now.

____________________________________________________________________

Use a calculator, total tuition is not automatically entered.
MY TOTAL TUITION IS...

____________________________________________________________________

STEP 6: 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
Cardholder Name
Account Number
Expiration Date

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




STEP 7: TERMS AND CONDITIONS
Please read our terms and conditions, registration cannot be
completed without signing and clicking the accept box below


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 8: 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
____________________________________________________________________

STEP 8: 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!