Summer Camp Registration  2009

Name(s)____________________________________     Age(s)________

Parent(s)____________________________________

Address_____________________________________

              _____________________________________

              _____________________________________

Phone_________________________

Emergency Contact___________________________________

Special Information/Allergies_______________________________

E-Mail_____________________________________

Camp Session(s)_______________________________
               
                               _______________________________

                               _______________________________

                               _______________________________

Payment $_____________

Check nbr.____________ 

or  Visa/MC__________________________________

exp_________     sig___________________________

The cost for morning camps is $110, and for afternoon camps is $130.  This covers instruction,
 materials, and snacks  There is a $10 discount for siblings.   Partial scholarships for low
 income and special needs students are available (call the Office at 814-234-2740 for more
 information).

Mail Registration form and check to:
         Art Alliance
         P.O. Box 811
         Lemont, PA 16851