Registration for Brushwork Alliance Art Camp

Please fill out the registration form below and you will be redirected to make the registration fee.

Artist Info

Health Info

Parent/Guardian Info

Choose Your Classes

Choose the weeks that you'd like your child to attend Elevation Arts Summer Camp

Emergency Contact Information

In case of emergencies, we need to know who to contact

  • Artist Info
  • Health Info
  • Parent/Guardian Info
  • Choose Your Classes
  • Emergency Contact Information

Artist Info

First Name

Last Name

Age

Grade

Birthday

School

E-mail Address

Social Media Pages

Health Info: Please list the information requested below. Please separate items with commas.

Health Conditions: Please list any health issues including physical, psychiatric, behavioral or any medications.

Immunizations: Please list all immunizations that have been received.

Dietary Restrictions / Allergies: lease list any dietary restrictions, food allergies or general allergies.

Parent/Guardian Info

First Name

Last Name

Relationship to Child

Full Address

Cell Phone

Alternative Number

E-mail

Name, Contact Number and Relationship for any one else authorized to drop-off/pick-up your child.

Choose Your Classes

General Rates Weekly Rate: $125

Dates & Themes

Photo Waiver: I grant my permission to use photos of my child for promotional purposes. (Website, social media, printed advertisements)

Emergency Contact Information

Full Name

Phone Number

Relationship to Child

Full Name of Doctor

Phone Number of Doctor