Registration Form

ARTCAMP 2006
June 5th-July 28th 2006 Grades 1-6
Monday thru Friday 9:30-12:30
All classes will be held at Fort East Martello Museum and Gardens
3501 South Roosevelt Blvd. Key West Florida 33040

$135.00 per week ($122.00 for KWAHS members)


Student Information:
First Name: ________________________Last Name: _______________________________
Age:_________ Grade: ______(As of September 2006)
School: ___________________________________
Address:________________________________ City _____________State_____ Zip__________
Parent / Guardian Information:
First Name________________________ Last Name________________________________
Phone/Home__________________ Work___________________ Cell___________________________
Email Address___________________________________________
Emergency Contact ____________________________________Phone_________________________
K.W.A.H.S will exhibit selected art in the annual Kids of Summer Show. K.W.A.H.S therefore reserves the right to retain the art produced by ArtCamp 2006 students for this purpose. All art will be returned to the students when the show is dismantled. All equipment and materials used to generate the final art piece is the property of K.W.A.H.S and the museum reserves the right to use the art on its website, for grant purposes and in other art exhibits. K.W.A.H.S reserves the right to photographs students in the classroom. If you do not agree, please indicate your preference.
______Yes, you may photograph my child. _____No, you may not photograph my child.

Method of Payment:

_____$135 per week ______$122 ( I am a KWAHS member)

________Check _____Cash
_____Visa _____Mastercard ______ Amex
Credit Card # ________ _________ _________ ________
Expire Date:________________ Today’s Date:__________________
Signature on Card:____________________________ Total Paid:_____________

Class Selection (please check)
___Grade 1: 1. Bold Bright Baron: June 5-9th. Time: 9:30 -12:30
___Grade 2-3: 2. Crawfish Jack and Mama Tilly: June 12-16th. Time: 9:30 -12:30
___Grade 3-4: 3. Whirligig Boxes: June 19 -23rd. Time: 9:30 -12:30
___Grade 4: 4. To The Lighthouse: June 26 - 30th. Time: 9:30 -12:30
___Grade 5 5. Composing With This and That: July 3-7 Time: 9:30 -12:30
___Grade 5 6. Stanley’s Sensational Sculptures: July 10-14 Time: 9:30 -12:30
___Grade 6 7. Sculpture As A Picture: July 17-21 Time: 9:30 -12:30
___Grade 6 8. Storytelling Prints: July 24-28 Time: 9:30 –12:30

Registration Procedure
Cost: Each 1 week session is $135.00 (or $122.00 for KWAHS members).
Payment is due upon registration. Tuition includes all supplies.
Space is limited to 12 children per class session.
Call Suzanne Pereira, Education Coordinator, KWAHS at 305-295-6616 Ext 27 to register by phone using your visa, mastercard or amex card. You may fax your completed application to 305-295-6649 / Att: Suzanne Pereira.

PLEASE DO NOT MAIL YOUR APPLICATION.