The Clay Center - Public Programs Registration Form

funding provided by:	accessibility:	find us on:	contact us press room privacy statement email sign-up employment
			Copyright © 2001 - 2012 Clay Center for the Arts & Sciences of West Virginia. All rights reserved. Content Management Solutions By TERRADON Communications Group, LLC

Workshop Participant First Name:
Workshop Participant Last Name:
Workshop Participant Age:	456789101112131415161718+
Workshop Participant Grade:	pre-KK123456789101112N/A
Parent/Guardian First Name:
Parent/Guardian Last Name:
Primary Contact Phone Number:	() -Second partThird part
Secondary Contact Phone Number:	() -Second partThird part
Street Address:
City:
State:
Zip Code:
Email Address:
Check here if you need a hard copy confirmation instead of e-mail:
Are you a Clay Center member?:	Yes No
Please list any allergies:
Please list any special needs or other information that would be helpful to instructors:
Workshops you would like to register for:	Nature Camp, Summer Discovery Camp, Monday, June 24 – Friday, June 28, 10 am – 2 pm at Kanawha State Forest, Grades 3 - 7(rising), Members: $115 & Non-members: $135, Registration Deadline: June 17 Garden Together, Daily Family Camp, Monday, July 1, 10 am – noon, Member Family: $30 & Non-member Family: $40 (Limit 4 per family), Registration Deadline: June 24 To the Stars! Daily Family Camp, Tuesday, July 2, 10 am – noon, Member Family: $30 & Non-member Family: $40 (Limit 4 per family), Registration Deadline: June 24 Go Green! Daily Family Camp, Wednesday, July 3, 10 am – noon, Member Family: $30 & Non-member Family: $40 (Limit 4 per family), Registration Deadline: June 24 We Are Family! Daily Family Camp, Friday, July 5, 10 am – noon, Member Family: $30 & Non-member Family: $40 (Limit 4 per family), Registration Deadline: June 24 Build it!, Summer Discovery Camp, Tuesday, July 9 – Friday, July 12, 10 am – noon, Grades: 2-6 (rising), Members: $65 & Non-members: $80, Registration Deadline: July 1 Filmmaking Camp, Summer Discover Camp, Monday, July 15 – Friday, July 19, 9 am – noon, Grades: 3-7 (rising), Members: $90 & Non-members $105, Registration Deadline: July 8 Kids Can Act! 2.0, Summer Discovery Camp, Monday, July 22 – Friday, 26, 1 – 4 pm, Grades: 3-7 (rising), Members: $90 & Non-members: $105, Registration Deadline: July 15 Critters Camp, Summer Discovery Camp, Tuesday, July 23 – Friday, July 26, 10 am – noon, Grades K-3(rising), Members $65 & Non-members $80, Registration Deadline: July 15 A Teen’s Guide to Acting, Summer Discovery Camp, Thursday, July 25 & Friday, July 26, 6 – 9 pm, Grades 8 - 12(rising), Members: $40 & Non-members: $50, Registration Deadline: July 18 Art-ventures I, Summer Discovery Camp, Tuesday, July 30 – Friday, August 2, 10 am – noon, Grades K-2nd (rising), Members: $65 & Non-members $80, Registration Deadline: July 23 Art-ventures II, Summer Discovery Camp, Tuesday, July 30 – Friday, August 2, 1 – 3 pm, Grades 3 – 5 (rising), Members: $65 & Non-members $80, Registration Deadline: July 23 Five Senses Exploration, Summer Discovery Camp, Tuesday, August 6 – Friday, August 9, 9:30 – 11 am, Grades: PreK-1st (4 years old), Members $40 & Non-members $50, Registration Deadline: July 30
How did you hear about this program?:	Clay Center E-mail Blast Poster Flier Clay Center Website Word of mouth Member Magazine Facebook Twitter Other
If you selected other, please list how you heard about this program.:

ClayCenter

public programs