Summer c Registration

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Home
Kids World
Gifts for Angels
- Gifts for Angeles Home
  - GFTRegistration
Arts in Education Blog
- Our Friends
Our Schools
- Current Students
  - Tuition services Online
- Former Students
The Board
Donor Sponsorship
Store
Employment Portal
Capabilities Statement
Category
Registered Agent
Alchemically Me
Changingnarratives
Student Cultural Exchange

Dates:

Session I June 10-July 12

Performers camp $170/week

Session II July 15-Aug 16

Love LA Camp $170/week session II

Times:
Camp 9am-4pm
Before Camp 7am to 9am
After Camp 4pm to 6pm

Summer Camp Registration

* Indicates required field

Select One *

Child's Name *

First

Last

Birthdate (mm/dd/yyyy) *

Choose One *

male female

Please select yourT-shirt size *

Grade entering in the Fall *

Choose as many as apply *

African Dance Advance Ballet Acting 101 Beginning Ballet Boxing Jazz Voice & Diction Play Production Intermediate Ballet Hip Hop Kickboxing/Martial Arts Creative Writing

Please check classes that your child is interested in.

2nd Child's Name *

First

Last

Birthdate (mm/dd/yyyy) *

Choose One *

Male Female

Please select yourT-shirt size *

Grade entering in the Fall *

Choose as many as apply *

African Dance Advance Ballet Acting 101 Beginning Ballet Boxing Jazz Voice & Diction Play Production Intermediate Ballet Hip Hop Kickboxing/Martial Arts Creative writing

3rd Child's Name *

First

Last

Birthdate (mm/dd/yyyy) *

Choose One *

Male Female

Please select yourT-shirt size *

Grade entering in Fall *

Choose as many as apply *

African Dance Advance Ballet Acting 101 Beginning Ballet Boxing Jazz Voice & Diction Play Production Intermediate Ballet Hip Hop Kickboxing/Martial Arts Creative Writing

Mother/Guardian Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

SecondaryPhone Number *

Company *

Please download, print, sign and return the following forms. You may pay your registration fee following the submission of your application. If you have any questions please email: [email protected] Happy Camping!

liabilitysignatureform.pdf
File Size:	133 kb
File Type:	pdf

Download File

emergency_information_form-english-enabled.docx
File Size:	47 kb
File Type:	docx

Download File

liability_waiver_and_photo_release_registration_form_for_free_classes.pdf
File Size:	182 kb
File Type:	pdf

Download File

Father/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Comment/Questions *

How did you hear about us? *

Name of who referred you *

Authorization Card

Name *

First

Last

For your child's safety, Kids World will only release your child to the person enrolling the child and the person(s) you specify below. Changes must be made in writing.

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Medical Card

Name of Emergency Contact *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Relationship to the child *

Grandparent Aunt/Uncle Sister/Brother Friend Other

Explain *

Does your child have any known allergies? *

Yes No

If yes, please explain.

Allergies/Notes *

Does your child use an epipen? *

Yes No

Please specify child in the Allergies/Notes section.

Statement of Certification and Acknowledgement *

I certify that the above information is correct to the best of my knowledge. I agree to receive promotional material via the Kids World Newsletter.

Name of Primary Physician *

First

Last

Private Insurance Name *

Phone Number *

Medi-cal/Healthyfamilies ID no. *

Group No. *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Secondary Ins Name *

Group No. *

Address *

Line 1

Line 2

City

State

Zip Code

Country

I agree to receiving marketing and promotional materials

Submit

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367 Third Ave. Scottdale, GA 30079

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