YOUNG ARTISTS THEATRE

SUMMER CAMP STUDENT ENROLLMENT FORM

Please print out and mail with check or money order to:

The Young Artists Theatre

Cherry Tree Center 11200 Scaggsville Road #127, Maple Lawn, MD 20723

or FAX with credit card number/expiration date to: 301-604-2845

Please use additional forms for additional children

STUDENT’S NAME:_____________________________________________________________

BIRTHDATE:_______________AGE: __________SCHOOL GRADE:_____________________

PARENT’S NAME(S):___________________________________________________________

ADDRESS:_____________________________________________________________

HOME PHONE:______ WORK PHONE:__________E-MAIL :__________________________

Any special circumstances, needs or physical challenges?

How did you hear about Young Artists?

SESSION ATTENDANCE

FULL DAY SUMMER CAMP

JUNE 1 WEEK _____ JUNE WEEK_____

JUNE “JOIN AS YOU CAN” (SPECIFY DATES________________ JULY HOLIDAY_______
JULY 3 WEEK_______ AUG 3 WEEK______AUG 1 WEEK_______

KINDERCAMP:
JUNE SESSION I:___ JUNE SESSION II___

JULY SESSION III ___ AUG SESSION IV_____

TUITION TOTALS

SUMMER TUITION FEES:______

Minus any discounts:__________

TOTAL:______________________

Check or Money Orders are payable to Young Artists, Inc.

For VISA, M/C , please fill out space provided below:

NAME ON CARD:_________________________________________________________

ACCOUNT #_________________________________________3 DIGIT SEC CODE_____

EXP.DATE_______SIGNATURE___________________________________________

PAYMENT PLAN: A four payment installment plan is available by prior arrangement through May l, 2010 for FULL DAY SUMMER CAMPS ONLY. Please phone 301-604-2844 or

e-mail us for details.

REFUND POLICY: Full refund, minus $100 processing fee, will be made prior to June 1, 2010. No refunds will be made after that date. No refunds will be made for Spring Break Camp tuition.

LIABILITY: Young Artists Theatre Center, Inc. reserves the right to modify curriculum and/or select instructors as necessary. Young Artists Theatre Center, Inc. assumes no liability for accident or injury occurring before, during or after program hours.

LATE PICK UP POLICY: A $15 fee will be assessed if a child is picked up more than 10 minutes after the program day ends. One 10 minute late arrival per family is permitted with a phone call to let us know you are on the way (301-604-2844)

CARPOOLING: Contact us for a list of interested parents near you.