Winter Camp Registration

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Student's Name *

First

Last

Student's Age *

2nd Student's Name *

First

Last

Student's Age *

3rd Student's Name *

First

Last

Parent's Name *

First

Last

Phone Number *

Email *

Confirm Email *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Student's Age *

Half Day or Full Day? *

Full Day 10AM - 4PM Half Day 10AM - 1PM Half Day 1PM - 4PM

Extended Care? *

Not Needed 8:30AM - 10AM 4PM - 5:30PM

Comment *

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Art Studio Academy
6055 Meridian Ave #60
San Jose, CA 95120

Almaden Valley, South San Jose

(408) 599-2456

Create@ArtStudioAcademy.org

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