June 15th-July 24th 2009 Grades K-9
Monday thru Friday 9:30-12:30
Fort East Martello Museum, 3501 South Roosevelt Blvd. Key West Florida 33040

Student Information:

First Name: _________________________Last Name:_____________________________

Age:_________Grade:______School:______________________________________________

Address: _________________________ City _____________State_____ Zip__________

Parent / Guardian Information:

First Name_____________________ Last Name____________________________________

Phone/Home_____________Work_________________Cell___________________________

Email Address______________________________________________________

Emergency Contact Name ________________________Phone_______________________

K.W.A.H.S exhibits selected art in the annual Kids of Summer Show. K.W.A.H.S reserves the right to retain the art produced by ArtCamp2009 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 are the property of K.W.A.H.S.

The museum reserves the right to use student’s art on the KWAHS website, for grant purposes and in other art exhibits. K.W.A.H.S photographs students in the classroom. If you do not want your child photographed, please indicate your preference by checking the appropriate box below.

 Yes you may photograph my child.  No you may not photograph my child.

Method of Payment $150 per week $135 ( I am a KWAHS member)

Check Visa Mastercard Amex Cash

CC# ____________ _____________ _____________ _______________

Expire Date:___________________ Today’s Date:________________________________

Signature on Card:______________________ Total Paid:___________________________

Class Selection ( please circle )

Week 1 Grade7-9 Age 13,14,15 June 15-19 2009. Time: 9:30 -12:30 Looking In, Looking Out, Pinhole Photography.

Week 2 Grade K-1 Age 6-7 June 22-26 2009 Time: 9:30 -12:30 Mario’s Clouds of Visions.

Week 3 Grade 1-2 Age 7-8 June 29-July 3 2009 Time: 9:30 -12:30 Buckteeth and Shut Up You Mouth.

Week 4 Grade 2-3 Age 8-9 July 6-10 2009 Time: 9:30 -12:30 Pop Art Tarts.

Week 5 Grade 3-4 Age10-11 July 13-17 2009 Time: 9:30 -12:30 Ships and Their Stories.

Week 6 Grade 4-5 Age 11 older July 20-24 2009 Time: 9:30 -12:30 Our Endangered Florida Keys – An Art Installation.

Registration Procedure

Payment is due upon registration. Tuition includes all supplies.

Call Suzanne Pereira, Curator of Education, 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.

Refunds: If a refund is requested, a reimbursement for the week will be made in full, only up until 7 days prior to the session start date. No reimbursements will be made after this cut off date. PLEASE NOTE: Parent/Guardian, it is museum policy that every student be accompanied by his/her guardian into and out of the museum at the beginning and end of every class. The museum accepts no responsibility for the safety of unaccompanied children. Student will be subject to reprimand by KWAHS staff members if he/she misbehaves in the museum.