SMArts Summer Camp Info and Permission Form

SMArts Summer Camp 2022

JULY 25th to 28th 2022 - 8am to 12pm

Registration Step 2 (of 2):

Additional Camper Information & Permission Form

IMPORTANT:
Step 2 is NOT a reservation for Summer Camp. Step 1 (Online Registration & Payment here) must be completed to secure a spot for your camper(s).

Submit One Form Per Camper Enrolled

CAMPER INFORMATION:
Camper Full Name

Camper Sale Registration Number:
(This is the Sale Number for your online registration and payment. You will have an email confirmation with this number after your enroll & pay through our online portal.)

Camper Gender

Camper Grade Entering

Camper T-Shirt Size (select one)

T-Shirt Notes (optional)

PARENT/GUARDIAN INFORMATION:
Parent/Guardian Full Name

Parent/Guardian Address (Include City, State and Zip)

Parent/Guardian Email(s)

Parent/Guardian Primary Telephone Number

Primary Phone Type

Parent/Guardian Alternate Phone Number

Alternate Phone Type

EMERGENCY INFORMATION:
Medical Treatment Permission:

If I cannot be reached, I give my permission to SEARK Concert Association and its representatives to take my child to Drew Memorial Hospital

Camper Doctor Full Name

Camper Doctor Phone Number

Alternate Emergency Contacts:
Please list two people whom we may contact in the event of an emergency if the parent/guardian is not available.

Alternate 1 - Full Name

Alternate 1 - Phone Number

Alternate 2 - Full Name

Alternate 2 - Phone Number

OTHER TERMS, CONDITIONS & PERMISSIONS

Media Permission

I give my permission to use photography, video, and/or audiotape in which my child may appear in SEARK marketing and publicity.

Personal Items

l understand SEARK is not responsible for any personal items, including clothing, cell phones, games, and money, brought to campus.

Electronic Device Use

I understand that my child should not use a cell phone, iPad, or any other electronic device while attending Smarts camp.

Appropriate Behavior

I have discussed appropriate behavior with my child and am aware that such behavior will result in dismissal from Smarts camp.

Acceptance of Terms

By checking this box and adding my name below, I hereby agree to the above terms & conditions.

Full Name of Parent/Guardian Agreeing to the Terms

SMArts Summer Camp 2022

JULY 25th to 28th 2022 - 8am to 12pm

Registration Step 2 (of 2):

Additional Camper Information & Permission Form

Website by

Hours of operation

Varies. Call 870-460-1888
for assistance

LOCATION:
SEARK Concert Office
UAM Fine Arts Center
371 University Drive
Monticello, AR 71656

contact us

PO Box 3072
Monticello, AR 71656

+1 (870) 460-1888
searkconcertassociation@gmail.com

Menu

Website by

SMArts Summer Camp 2022

JULY 25th to 28th 2022 - 8am to 12pm

Registration Step 2 (of 2):

Additional Camper Information & Permission Form

Website by

Hours of operation

Varies. Call 870-460-1888 for assistance LOCATION: SEARK Concert Office UAM Fine Arts Center 371 University Drive Monticello, AR 71656

contact us

PO Box 3072 Monticello, AR 71656 +1 (870) 460-1888 searkconcertassociation@gmail.com

Menu

Website by

Varies. Call 870-460-1888
for assistance

LOCATION:
SEARK Concert Office
UAM Fine Arts Center
371 University Drive
Monticello, AR 71656

PO Box 3072
Monticello, AR 71656

+1 (870) 460-1888
searkconcertassociation@gmail.com