Adaptive Art Camp For Children With Special Needs

Registration Forms:
A.R.T.S. Camp
Clay Class

A.R.T.S.

North Sutton, New Hampshire
603.927.4050

ADAPTIVE ART CAMP FOR CHILDREN WITH SPECIAL NEEDS

Printable Version (PDF)

2011 - JUNE 27 thru JULY 8
SESSION 1: MONDAY, WEDNESDAY AND FRIDAY MORNINGS 9 AM TO 11 AM
SESSION 2: MONDAY, WEDNESDAY AND FRIDAY MORNINGS 1 PM TO 3 PM
COST; $250 FOR THE SESSION. COST INCLUDES ALL ART PROJECT MATERIALS, FIRING OF CLAY PROJECTS, INSTRUCTION, AND SENSORIMOTOR PLAY ACTIVITIES.

For Further Information, Call Cindy Best At 603-927-4050

Student's Name

Student's Age

Mailing Address

Town/City

State

Phone

Email Address

Today's Date

Child's Prior Clay/Art Experience

What would you like to see your child get out of Art Camp?

*Please plan on joining your child for the first 15 minutes of their very first clay class. This will be a time for you and your child to communicate goals, concerns and strategies.

Were You Referred By Anyone?

Are You Comfortable With Me Acknowledging the referral With A Thank You Note?

If yes, please provide referring person's name and address

EMERGENCY INFORMATION:

Please list any allergies

In case of an emergency, call:

Name

Phone #

Cell #

- WAIVER: I hereby agree to indemnify and hold harmless Cindy Best, Meredith Byrd Miller and Michelle Pritchard from any liability of claim or action for damages from or in any way arising out of the participation in any program by the person registered. In case of accident or illness, Cindy Best has my permission to secure medical attention as deemed necessary, if unable to communicate with parent or guardian directly.

Name Of Parent or Guardian

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