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Winter Camp Registration
City, State, Zip
Please provide the number you would like to be contacted at in case of an emergency.
Does your child have any known allergies?
Winter Camp (12/18-12/22)
Please select the days your child will attend camp.
I consent that photographs, audio tapes or video tapes of me and/or my child may be taken by members of Good Sam Arts Faculty and Staff, and/or the media before, during or after classes while at Good Sam Arts. Said materials may be used for promotional purposes including television, newspaper, web site, advertising and other purposes for Good Sam Arts. Furthermore, I hereby consent that such information, sound, photographs, videos and files from which they are made shall be the property of Good Sam Arts. No names of students will appear on publicity.
I have read the following: I may make payment by check made out to "Good Sam Arts" or by credit card at http://arts.goodsamtally.org/make-payment/. After submission of this form, you will receive a confirmation email with a statement attached, camp spots are not secured until payment is received. I understand that refunds are given only if the camp does not meet minimum enrollment.
I have read the following: I understand that by registering online I am committing to make payment of the entire tuition. Should I wish to withdraw from a camp, I understand that a WITHDRAWAL FORM must be submitted to Good Sam Arts, and that my withdrawal will take 10 days to complete. Therefore, I will be liable for any tuition payments that are due within that 10 days.
Good Sam Arts
3720 Capital Circle SE
Tallahassee, FL 32311
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Good Samaritan UMC
Good Samaritan Academy
Good Sam Arts - Uniting Art & Soul
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