SUMMER ART CAMP REGISTRAT

SUMMER ART CAMP REGISTRATION: 2012 CHILD’S NAME: __________________________________________________________________ BIRTH DATE: _______/_______/_______ SEX: ____MALE ____ FEMALE AGE: __________ ADDRESS: ______________________________________________________________________ CITY:_____________________________________________ STATE: ________ ZIP: ___________ EMAIL: _________________________________________________________________________ SPECIAL CONSIDERATIONS, ALLERGIES, MEDICATIONS?_________________________________ PARENT/GUARDIAN:_______________________________________________________________ HOME TELEPHONE: _________________________ WORK TELEPHONE: _____________________ HOW DID YOU HEAR ABOUT THE CAMPS? _____________________________________________ EMERGENCY CONTACT NAME: ________________________________________ PHONE __________________________ PHYSICIAN: _____________________________________ PHONE __________________________ NAME OF CAMP #1:_______________________________________________________________ LOCATION: ___________________________________________ DATE: _____________________ NAME OF CAMP #2:_______________________________________________________________ LOCATION: __________________________________________ DATE: _____________________ Total Amount enclosed $___________ (if additional space is needed, attach another sheet) Fees are not refundable. Make checks payable to: Arts Council. PO Box 2797, Rock Hill, SC 29732. Members $75 Non-Members $85 Children will have a 10-15 minute break halfway through the class each day. Juice or lemonade will be served. Children are allowed to have snacks brought from home. Due to higher number of children with peanut allergies, please bring snacks that are peanut free. Thanks! If child/ward (child’s name)_________________________ should require minor or major medical treatment during participation in arts camp activities, I give my permission to the Arts Council to take my child/ward to the emergency room of the nearest hospital, if necessary, for the administration of treatment. I, the undersigned parent or guardian, hereby freely and knowingly waive and release the Arts Council, its agents, employees, sponsors, and board from any and every liability and responsibility whatsoever for personal injury, property damage, or other loss sustained by the child named above as a result of or arising out of the child’s participation in any activity conducted by the Arts Council. I assume all risks and hazards incidental to the conduct of the activity. Parent’s/Guardian Signature _________________________________ Date __________________ ARTS COUNCIL OF YORK COUNTY PO Box 2797 | Rock Hill, SC 29732 Phone: (803) 328-2787 | Fax: (803) 328-2165

WEEK 1 ( JUNE 4-8 ) REGISTRATION DEADLINE: MONDAY, MAY 21 Let’s Dance To The Music with Juanita Foster June 4-8, 9am - 12pm | Ages 6-9 Community Performance Center Children develop self-esteem while learning to act and dance. They will learn different dance movements to popular music. Camp will conclude with a student performance on the last day. Clay Creations with Bob Doster June 4-8, 9am-12pm | Ages: 6-8 Center for the Arts, Classroom Students will learn the “pinch” method to build cups, bowls, dinosaurs, turtles or “monster heads.” Clay Creations with Bob Doster June 4-8, 1-4pm | Ages: 9-12 Center for the Arts, Classroom Students will learn the “pinch” method to build cups, bowls, dinosaurs, turtles or “monster heads.” WEEK 2 ( JUNE 11-15 ) REGISTRATION DEADLINE: MONDAY, MAY 28 Beginning Techniques in Drawing with Ashley Beard June 11-15, 9am - 12pm | Ages 6-9 Center for the Arts, Classroom Learn how to use basic lines and shapes to create drawings from observation and imagination using graphite, pen and ink, oil pastel, and charcoal. Drawing from Observation with Ashley Beard June 11-15, 1-4pm | Ages 10+ Center for the Arts, Classroom Learn how to see with an artist’s eye and draw using traditional drawing techniques involving perspective, proportion, and value using graphite, pen and ink, oil pastel, and charcoal.