The Dairy Barn Arts Center Proudly Presents: Teen Camp 2015 June 22nd - 26th Teen camp is designed to provide arts enrichment for teens in 8th-10th grade. Teen Camp is one of Education Director Lyn Stanton's favorite things! Dairy Barn Artist in Residence Lisa Brooks will be coming back to the Barn to co-teach with Lyn for a wonderful week! This week is going to be a veritable smorgasbord of creativity and productivity. Students can participate in this immersive arts experience and explore different types of art and art processes. The wall between the Ceramics Room and the Art Room will be opened for the week to create a giant shared studio space. Activities will include: Designing and screen printing T-Shirts, explorations in ceramics, outdoor installation arts and much more. Student Name:_________________________ Student Age: __________ Entering Grade: _________ Parent Name: ________________________________________ Home Phone: _________________ Cell: ___________________ Address: _____________________________________________ Email: _______________________________________________ Emergency Contact: _________________ #_________________ Allergies (Please List) ___________________________________________ T-Shirt Size: (Circle one) Small Medium Large X-Large XX-Large Students are encouraged to bring additional fabric items to print on. These items should be cotton, linen, silk; cloth that can take ink! (think bags, bandannas, jeans etc.) Daily Schedule Morning Arrival: 9:45-9:55 Students are to bring: Bagged Lunch and Snack Sunscreen/bug spray if needed Water Bottle Comfortable shoes (No Flip Flops) Clothing that can get dirty/stained Personal media device (music and headphones) to be used only during open studio time Join Or Renew Your Membership Here: Just Add To The Total! FEE: $250.00 Or MEMBERS $225.00 Membership Fee (if applicable) $100:____________ Teen Camp Fee: $250.00/non-members $225.00/members: _____________ Total Enclosed/Paid :______________ Please make Checks payable to The Dairy Barn (Circle) Cash Check Credit Card #___________________________ Exp_________CVV______ Credit Card Policy: A 5% of total fee is added to cover cost of credit card service (Checks preferred!) In case of emergency, I request that I/we be contacted. I give permission for emergency medical treatment and transfer to the nearest medical facility. I agree to assume all costs related to such treatment and I release the Dairy Barn from any responsibility for injury or illness that may occur while my child participates. I give permission for my child to participate in the Teen Art Camp (Please Check) I allow my student to be photographed for press and publicity (Please Check) Parent or Guardian Signature: ____________________________________________Date: __________________________