Oak Street Studios Summer Camp Scholarship Registration - Side x Side | Awakening Tomorrow's Innovators through Art

Summer Camp/Class Session *

Select the camp session from dropdown menu above

Student Name *

First

Last

Age of Student *

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Daytime Phone *

Other Parent/Guardian Name (if applicable)

First

Last

Other Parent/Guardian Phone

Other Parent/Guardian Email

Please list any physical limitations, restrictions, allergies, or medical conditions to be aware of, or medicine taken by your child: *

May list "none" if applicable

I give my child permission to attend organized field trips with the studio *

Please child to

I give my child permission to be photographed and for photos to be used in promotional materials *

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