Windover Art Center
Registration Form 2008

Name		Age    Date of Birth
Street Address
City/State/Zip
Work Phone Email		Home Phone             Cell Phone
		Name of Parent(s)/Guardian   Occupation
		Person Responsible for Tuition and Fees & Billing Address
WEEK/ THEME	DATE	TUITION      $200	BANGOR BUS $45/WK	HAMPDEN BUS $40/WK	PARENT TRANSPORT (PLEASE CHECK)	EARLY REG DISCOUNT BY 5/18/08 $10/WK	MULTIPLE WEEK DISCOUNT $10/WK	SECOND CHILD DISCOUNT $10/WK	ENROLL A FRIEND DISCOUNT $10/WK	WEEKLY  TOTAL
1 COLOR	6/23-28
2 MOVE- MENT	6/30-7/3
3 SOUND	7/7-11
4 LIGHT	7/14-18
5 EARTH	7/21-25
6 WATER	7/29-8/1
7 SHAPE/3D	8/4-8
8 BEAUTY	8/11-15
9 CELEBRATE	8/18-22
		For second child discount, list names of other siblings attending and attach with their form I agree to pay the Total Due prior to camper's arrival (Signature of Parent or Guardian)				Total Due
						Refunds are not available.
		FOR OFFICE USE ONLY:  TUITION DUE: PAID BY (GUARDIAN, SCHOLARSHIP, OTHER): TOTAL PAID (AMOUNT, DATE, CHECK #): BALANCE DUE:
		EMERGENCY CONTACT INFORMATION This section must be completed prior to camper's attendance at camp.  Please print.   If parent(s)/guardian are not available in an emergency, notify:
FIRST CONTACT: Name		Phone
		Relationship to Child
SECOND CONTACT: Name		Phone
		Relationship to Child
		Allergies & Other Medical Information/Social Issues
Family Physician		Phone
Hospital Preference
		If the above person(s) cannot be contacted, I give permission for my child to receive emergency medical treatment.  Windover programs are supervised by trained staff and are operated in such a way as to minimize risk.  The camper must agree to abide by all Windover rules and regulations for the health, safety and welfare of the individuals and the Windover community.  Windover is not responsible for injuries incurred in the course of any accidental happening during camp activities.  Windover reserves the right to use photographs of children for promotional purposes.  Polite and appropriate behavior is expected at all times by everyone.  I have received and read the Rules, Attendance and Disciplinary Policies and agree to the terms as outlined in each. For "What to Bring" and "The Rules", follow this link: http://www.windoverartcenter.org/What To Bring.html   For "Policy Statement" and Disciplinary Policy" follow this link:  http://www.windoverartcenter.org/Policy Statement.html   I have read and understand the above.
		Camper Signature & Date
		Parent/Guardian Signature & Date