Art Camp 2016

Address *

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Student 1 Name *

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Last

Birthday (month/day/year) *

Parent 1 Email *

Parent 2 Email *

How did you hear about us? *

Referral Name *

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May we e-mail you our newsletter with session info, special events and promotions? *

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School Name *

Student 2 Name *

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Last

Birthday (month/day/year) *

Check All That Apply *

(CHECKBOX REQUIRED) I acknowledge and understand that Dionne Victoria Studios has a NO NUT product requirement for all Participants. Please do not bring nut products to class. (CHECKBOX REQUIRED) I have read Dionne Victoria Studio's class policies on their website and agree to the terms and conditions. I acknowledge that Dionne Victoria Studios may periodically photograph or video its participants and their artwork and I grant my full permission for Dionne Victoria Studios to photograph, video, record, or reproduce images of my child and their artwork.

School Name *

Student 3 Name *

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Register for Camp