Summer Camp Registration

Time To Clay....Paint Pottery + Glass Fuse + Create in Clay

Time To Clay 2011 Summer Camp Registration Form

Please check the date/ dates of the sessions you wish to attend.

One Day Mini Camps 6 yrs + $25.00 each 10:30- 12:30 p.m.

Stars & Stripes July 12^th _____ or Aug 4^th _____

Bird's Nest July 14^th _____ or Aug. 9^th _____

Fiesta Chip n' Dip July 19^th _____ or Aug. 11^th _____

Clay Butterfly July 26^th _____ or Aug. 18^th _____

Create a Canvas July 21^th _____ or Aug. 16^th _____

Gnom-e-o & Juliette July 28^th _____ or Aug. 23^rd _____

Footprint Surf Boards Aug. 2nd _____ or Aug. 25^th ______

One Day Tween Camps 10 yrs + $25.00 each 6:30- 8:30 p.m.

Squeezy Art July 22nd _____
Canvas Painting Aug. 12th _____

Glass Jewelry Dish Aug 26^th ______

5-Day Art Camp 8 yrs + $180.00/ $165.00 sibling 10:30- 3:00/ 5 days

Into the Wild July 11 - 15th Sold Out

Fun in the Sun July 18 - 22nd Sold Out
Kids N Kakes July 25 - 29th _______

Treasure Hunters Aug 1- 5th _______

Peace, Love & Pottery Aug. 8 - 12th Sold Out

P.J.'s & Pottery Aug. 15 - 19th Sold Out

Best of….Summer Aug 22-26st ________

Child’s Name: _____________________ Parent’s Name: _________________

Address : _________________________City/ State : ______________________

Phone # : _______________________ Cell # : _______________________

E-mail : ______________________________

Birth Date : _________________________ Age : ______________

List Medical Conditions/ Allergies______________________________________

Emergency Contact Name : ______________________ Phone # _____________

Day Session payment is due at registration. Please check off the session your child will be attending and enclose payment.

Multi Day Sessions- $50.00 deposit due at registration. Balance due on the first day of camp session.

Refund Policy- Full refund will be issued for cancelations requested 14 days prior to session date.

I hereby declare that I have filled out the above information to the best of my knowledge and have informed staff of all information needed in case of emergency. I understand the refund policy.

Parent Signature : ______________________________ Date: __________

Mail form and payment to: Time To Clay 228 Daniel Webster Highway Nashua, NH 03060