2026 Summer Art Camp Registration Form for 9 to 11 Years Old

Elk City Arts Council Summer Art Camp Registration

Ages 9 to 11 years old
Please fill out one registration per camper!
Camper Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Parent / Guardian Name*

First NameLast Name
Email*
example@example.com
Phone Number
Format: (000) 000-0000.
Mobile Phone Number*
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contact Information in Case of Emergency
Name*

First NameLast Name
Contact Number*

Area CodePhone Number
Relation to camper*
Name

First NameLast Name
Contact Number

Area CodePhone Number
Relation to camper

Medical Release Form and Emergency Procedures
EMERGENCY MEDICAL RELEASE:

I understand that participation in Elk City Arts Council Summer Art Camp activities involves certain degree of risk and can be physically, mentally, and emotionally demanding. I have carefully considered the risk involved and have given consent for myself or my child to participate in this activity. I also understand that participation in this activity is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release Elk City Arts Council, the activity coordinators, volunteers, related parties, or other organizations associated with the activity from any and all claims or liability arising out of this participation.

In case of emergency involving my child, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the medical provider selected by the adult leader in charge to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for my child. Medical providers are authorized to disclose to the adult in charge examination findings, test results, and treatment provided for purposes of medical evaluation of the participant, follow-up and communication with the participant’s parents or guardian, and/or determination of the participant’s ability to continue in the program activities.
ALLERGIES (Please list all allergies):
Please explain on the field provided including any food the camper is allergic to
MEDICAL CONCERNS AND MEDICATIONS
Please provide the details, the name of the medication and period of intake
Special Needs

The following questions allow us to help your camper have the best camp experience possible.
Has your camper ever been identified as disabled?

YESNO
If yes, check any of the following that apply to your camper:

Learning DisabliitiesSpeech Language Behavior DisordersPhysical TherapyVisionHearing
If yes, what special accommadations or modications are needed?
Does your camper have an IEP or 504 plan in place?

YESNO

Elk City Arts Council Summer Arts Camp Agreement
Elk City Arts Council has permission to use any photos or film of our camper during the Summer Youth Camp that may be used for publicity purposes, including the web, now or for future use.*

YESNO
CODE OF CONDUCT

1. One basic expectation is strictly enfored at Elk City Arts Council Summer Arts Camp; "Don't hurt anyone." That means physically, emotionally or any other way.

2. Behavior at Elk City Arts Council Summer Arts Camp is based on mutual respect among teachers and campers. Campers are expected to be considerate of others and to treat the other campers, faculty, guest artsits, supplies and the building, which we occupy with respect.

3. In fairness to all the campers and in order to maintain a warm and relaxed atmosphers; Elk City Arts Council Summer Arts Camp reserves the right to dismiss campers who demonstrate by their behavior that they do not wish to be there.

4. A time-out approach will be used with campers who demonstrate disruptive behavior. If behavior problems continue, parents will be notified and together, staff; parents and participants will develop solution. Failing that, the camper will be dismissed from the program and tuition will not be refunded.

5. So each camper will receive the best experience, each class is a closed class, no person without permission is allowed to watch.

6. Each camper will need to be dropped off at least 10 minutes prior to the campers first class of of the day, and will need to be picked up within 15 minutes of the campers last class of the day. Multiple late pick-ups without warning may result in the camper being dismissed from the program.
My signature below confirms that I have read and understand the terms and conditions of the Summer Camp Contract, and I agree to all the terms and conditions contained herein.*
Today's Date

MonthDayYear
Date

SUMMER ARTS CAMP CLASS SCHEDULE
SCHEDULE

JUNE 1, 2026 THROUGH JUNE 25, 2026

9:00 AM TO 11:45 AM

MONDAY THROUGH THURSDAY

SHOWCASE JUNE 25, 2026 AT 7 PM

CLASS LOCATION:
SUSAN POWELL FINE ARTS BUILDING

TUITION $35 A CLASS

A T-SHIRT IS INCLUDED WITH EACH REGISTRATION

*Limitied class size. Please note: 5 or more campers per class or it will be canceled.*

MONDAY AND WEDNESDAY

9:00 AM TO 10:15 AM

ARTS AND CRAFTS

or

S.T.E.A.M.

10:30 AM TO 11:45 AM

ART FOR BEGINNERS

or

MUSIC FOR KIDS

TUESDAY AND THURSDAY

9:00 AM TO 10:15 AM

MUSICAL THEATRE

or

DANCE FOR BEGINNERS

10:30 AM TO 11:45 AM

YOUTH ACTING

or

CREATIVE WRITING

S.T.E.A.M. (AGES 9 TO 11)

This summer we are going to focus on Art that goes hand in hand with science, technology, engineering and math--- STEAM! Join us for building our own fidget spinners & mazes, growing crystals, dyeing flowers, coloring geometric patterns, foldable 3D crafts, and more! Of course, we will also incorporate summer holidays and fun! Join us in STEAM where each student will create as they work towards a showcase.
ARTS AND CRAFTS (AGES 9 TO 11)

Arts and crafts activities can enhance the children’s dexterity and agility. With the enhancement of fine motor skills and much practice, a child’s manual dexterity, artistic skills, and speed will also increase. Join us in Arts and Crafts where each student will craft and create numerous projects and work towards a showcase.
ART FOR BEGINNERS (AGES 9 TO 11)

Love to create, draw or paint? Want to learn how? Join us in Art for Beginners where each student will learn different art mediums and work towards a showcase.
MUSIC FOR KIDS (AGES 9 TO 11)

Love music? This class is for you! Come sing, learn to play instruments, and simple partner dances. Join us in Music for Kids! We will also be performing at a showcase.
DANCE FOR BEGINNERS (AGES 6 TO 11)

Come shake your groove thing while learning dance! Introduction to some of the basic dance steps. Learn terminology and have fun, while working towards a showcase.
MUSICAL THEATRE (AGES 9 TO 11)

Singing and danincing, oh my! An introduction to the world of musical theatre all while learning some basic skills. These include terminology, choreography, and more. These skills help build self-confidence and self-esteem all while preparing for a final show. All skill levels are welcome.
YOUTH ACTING (AGES 9 TO 11)

Your young actors will be introduced to the world of live theater all while learning some basic skills. These include terminology, warm-ups, acting games, the audition process, as well as the rehearsal process. These skills help build self-confidence and self-esteem all while preparing for a final show. All skill levels welcome.
CREATIVE WRITING (AGES 9 TO 11)

Learn how to write poetry, stories, and maybe even a play. Each student will learn skills to help improve their writing, working towards an anthology at the end of class

Elk City Arts Council Summer Art Camp Registration

Please fill out one registration per camper!

Contact Information in Case of Emergency

Medical Release Form and Emergency Procedures

Elk City Arts Council Summer Arts Camp Agreement

SUMMER ARTS CAMP CLASS SCHEDULE

Payment

Payment Methods