Keith Eccles Illustration, Design Studio, LLC

KEITH ECCLES ILLUSTRATION & DESIGN STUDIO
EIN 20-0676938
2008 WESTBANK SUMMER ART CAMP
Drawing, Painting, Cartooning, Working with Clay, Animation, & More
(Ages 5 through 18)
Mail in Registration accepted with deposit OR
IN-STUDIO REGISTRATION DATES:
Saturdays, May 3, May 17, and June 7 (9:00 am - noon)
906 Derbigny Street, Gretna LA 70053 (504) 227-2785

Please complete separate form for each child.

CHILD’S NAME

AGE

BIRTHDATE

MALE/FEMALE

SCHOOL:

PARENTS:

ADDRESS:

CITY:

STATE:

ZIP: (ZIP Code)

HOME PHONE:

WORK PHONE:

CELL PHONE:

EMAIL ADDRESS: (E-mail)

EMERGENCY CONTACT NAME:

EMERGENCY CONTACT RELATIONSHIP:

EMERGENCY CONTACT PHONE:

PLEASE SELECT THE DESIRED CAMP DATES (Hrs 8:30 – 3:30) – NO BEFORE/AFTER CARE

June 9-13:

June 16 – 20:

June 23 – 27:

July 7 – 11:

July 14 – 18:

July 21 - 25:

July 28 – Aug 1:

Have not decided:

PAYMENT TYPE:

GENERAL CAMP POLICIES :

The children will be working in various media – please send them in clothes appropriate
for painting, etc.
Campers should bring a bag lunch and drink each day. No electronic devices allowed.
3) Mid-morning and mid-afternoon snacks/drinks will be available to purchase. Please send
your children with change if you would like them to have anything other than what you
pack for lunch. All snacks will cost 50 cents each.
4) Campers will be expected to abide by all rules. Any discipline problems will be
communicated to you timely. There will be NO TOLERANCE for any camper touching
another camper or any belongings/artwork of other campers.
5) All Fees MUST be paid in full at least 2 weeks prior to the scheduled camp session;
otherwise, your space may be forfeited to someone on the waiting list.
6) You are not considered registered until you receive confirmation of the receipt of
your application and payment in full.
7) Rescheduling is allowed ONLY if we are notified at least 2 weeks prior to the
originally scheduled camp session – and is only allowed if space is available for
desired session.
8) Refunds of weekly fees are available ONLY if notified at least 2 weeks in advance
AND we are able to fill the spot left vacated.
9) There is NO makeup of partially attended weekly sessions.
10) Registration for Daily attendance is only available one week prior to the desired camp
session and ONLY IF we have not reached maximum capacity.
11) There is no before or after care offered. Drop off between 8:15 and 8:30 and pick up
between 3:30 and 3:45.
THANK YOU FOR YOUR FULL COOPERATION!
I have read and fully understand the above policies:

SIGNATURE: