2017 Summer Camp Selection Form

Camp Schedule

8:30-9:00am Drop-Off9:00-3:00pm Camp Activity3:30-6:00pm Extended Childcare( Optional)

Programs include:

Art: Art: Pencil/ oil pastel drawing, watercolor, acrylic painting, life sketching, fashion and pattern design, plein air paint out, 3-D design, clay work, scratch art, and all types of art craft.

Writing: Illustration, creative writing, and storytelling with art.

Student’s Name: __________________________________________ Age:______ First Name Last Name

E-mail: ___________________________________ Home Phone: _____________

PParents’ Cell #1_____________________ Parents’ Cell # 2__________________

Camp Selection: Theme [ ] Camp 1: 6/19-6/23 Magical World (Harry Potter series)[ ] Camp 2: 6/26-6/30 Animal Planet (Secret Life of Pets, Zootopia)[ ] Camp 3: 7/3-7/7( 4 days ) Knights and Princesses (Camp fee will be adjusted)[ ] Camp 4: 7/10-7/14 Disney/Cartoon World [ ] Camp 5: [ ] Camp 5: 7/17-7/21 Treasure Hunter[ ] Camp 6: 7/24-7/28 Time Traveler (Back to the Future)[ ] Camp 7: 7/31-8/4 Outer Space Adventure[ ] Camp 8: 8/7-8/11 Castles and Dragons[ ] Camp 9: 8/14-8/18 Atlantis

[ ] Registration Fee $25.00 (Waived for current students, returning students, or students who sign up for more than 3 camps.) [ ] Tuition: $425 for the 1st camp. $405 each if sign up for 2 camps. $375 each if sign up for 3 or more camps. Lunch is not included, but snacks and drinks will be provided.[ ] Material Fee: $25.00 (waived if sign up for two or more sessions). [ ] Extended Childcare $80.00 per session (3:00pm – 6:00 pm, M-F, Optional) Total: _____________________________ Federal tax ID: 26-2563905

Early Bird Discount (register by 4/15 and get $25 off per camp). Students can pay full amount before 4/15 to get discount. Let the office know that actual camps they plan to sign up before 6/1.

Please make check payable to: Ichen Art AcademyPlease send the check with the registration form to Ichen Art Academy by 6/1/2017

Refund policy: 100% refund available till 4/1 . 75% refund till 5/1 . 50% refund before 6/1. No refund after 6/15.

510-353-0860 | ichenartacademy.com | 43319 Mission Blvd., Fremont, CA 94539