Camp Create! 2024 Student Admissions Application

This form is to be completed by the parent or legal guardian of the student seeking admission to the camp. General Communications regarding the camp program will be made to parents, through email. In addition to this application, several consent and confirmation signatures will be required of the student's legal guardian on the first day of the program.

*Please note that camp instructors are credentialed artists and educators, but do not have specialized training to deal with unique medical or behavioral circumstances.

Information about the program is available on the Pro-Art website.

Student Information

First Name (student)

Last Name (student)

Date of Birth

Home Address (physical- Not P.O. Box)

School student attends

Grade (Rising)

Health Insurer (H.I.)

H.I. Policy #

Medications

Allergies

Disabilities

Medical conditions

Dietary Restrictions

Custodial Information- Parent/Legal Guardian

Name-Guardian

Primary/Emergency Phone Number

Email-Guardian

Mailing Address- Guardian

Secondary Phone Number

Contact Preference

Custodians

Custodial Restrictions

Conflicts-Scheduling

Notes

Consent: There are several forms of consent required of the legal guardian of a participating student, to be obtained at the onset of the program. These include the consent to initiate emergency medical treatment and to allow designee/s of the camp program to take photos and/or video of your child (documentation required for grant reporting). In addition, the camp program will ask for your consent to abide by the camp program's policies, including restrictions on the possession and use of cell phones by students and program attendance expectations. Checking the box below indicates that you understand the student applicant's participation in the camp program may be conditioned on your consent, as their legal guardian, in these matters.

By checking this box, I affirm my understanding that my child's participation may be conditioned on my consent to the program's forthcoming policies and procedures.

By checking this box, I affirm that I am the legal guardian of the student named in this application and that the information I have provided is accurate to the best of my knowlege.

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Camp Create! 2024 Student Admissions Application

Student Information

Custodial Information- Parent/﻿Legal Guardian

Custodial Information- Parent/Legal Guardian