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2019 Fruiggie Eco Art Summer Camp Program Registration
Child’s Information
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Child Name #1
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Age
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Address
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Child’s Home Phone
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Child Name #2
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Child Name #3
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Child’s Home Phone
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Medical
Please list any medical problems, including any requiring maintenance medication and treatment (i.e. Diabetic, Asthma, Seizures).
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Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?
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No
If yes, please specify.
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Is your child allergic to any type of food or medication?
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Does your child require a special diet?
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Parents/Guardian Contact Information
Parent/Guardian #1
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Home Phone
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Work Phone
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Cell Phone
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Occupation
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Parent/Guardian #2
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Home Phone
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Work Phone
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Cell Phone
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Employer
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Emergency Contact Information
Emergency Contact #1
Name
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Phone Number
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Phone Number
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Phone Number
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Email
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Relationship to Child
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Please Choose Camp Week(s)
Choose Any
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Week 1: Paper Making & Paper Mache
Week 2: Sculpting & Printing
Week 3: Ancient Arts & Crafts
Week 4: Musical Instruments around the world
Week 5: DIY Nature Jewelry, Accessory, and Fashion Designing
Week 6: DIY Children Bedroom Decor
Week 7: DIY Vegan cooking & Baking Class
Week 8: DIY School Supplies
Please choose how you heard about Fruiggie Eco Art Summer Program.
*
Fruiggie Website
Flyer
Word of mouth
Print advertisement (Please specify below)
School/Event (Please specify below)
Print advertisement
Online advertisement (Please specify below)
Other
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