A Spacious Place Summer Creativity Camp Registration

Young Artists Club Registration

Student’s Name

First Name *

Last Name *

Student’s Birthdate

T-Shirt Size

Add a "C" for child-sized t-shirt and an "A" for an adult-sized t-shirt

Parent’s (Guardian’s) Email Address

Student’s Address

Country

Address Line 1

City

State/Province

Postal Code

Parent’s (Guardian’s) Phone Number(s)

Work

Home

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Mobile

Parent’s (Guardian’s) Address (if different from student’s)

Country

Address Line 1

City

State/Province

Postal Code

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