To register, fill out the form below. Payment must be received to confirm registration. Checks payable to Artists’ Open Studio Inc.

For more information, contact Lindsey Esker at lesker80@gmail.com.

Camper Info

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Caregiver Name

First Name

Last Name

Parent/Caregiver Phone

Email

Emergency Contact

(###)

###

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Emergency Contact Phone

Please list any diagnoses your child has that we should be aware of:

How does your child best communicate?

What are your child's interests?

What sensory, behavioral, or physical accomodations are helpful to your child?

Please list any allergies your child has: