Art Camp Application

Camper Information
Name*

First NameLast Name
What age is the camper?*

Middle School (June 16-20)High School (July 7-11)
Sex*

MaleFemalePrefer not to sayOther
Date of Birth*

MonthDayYear
Date
Does the participant require any accommodations we need to be made aware of to ensure they have a great camp experience?
Does the participant have any food or environmental allergies we need to be made aware of?

Parent/Guardian Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I agree to receive communications from Signal Centers and its programs via text message, email, and other channels. I understand that message and data rates may apply for texts. Consent is not a condition of purchase. I can unsubscribe at any time.*

YesNo

My Products

Hart Gallery Art Camp

$300.00 Quantity

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Camper Information