Clone of 2015 Summer Art Camp Registration

ASA Summer Art Camp Registration

Complete form below to register. Any questions: afterschool@artstudentacademy.com
Student Name*

First NameLast Name
Student Age
Parent Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Cell or Emergency Phone*

Area CodePhone Number
E-mail:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Alternate Contact
Alt Contact Phone Number

Area CodePhone Number
Please select your class and age group
Choose a class.*

SORRY, CLASS FULLJune 22 - 24 All Ages, 9:30 am - 3:30 pm Mon - WedsSORRY, CLASS FULL June 22 -23July 20 - 22 All Ages, 9:30 am - 3:30 pm Mon - Weds
A preregistration deposit of $50. holds your childs place in 2015 Summer Art Camps

The Submit button will take you to Paypal payment page. You can use Paypal or credit card. The form will not be not submitted until deposit is remitted.

Questions: 919-880-7431 Theresa or 919-880-2858 Steve
Thank you
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ASA Summer Art Camp Registration