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Questions? Call us - 606.324.3175 ext. 311/310
Registration Form
Please return this form and payment at least 1 week prior to the scheduled class date. Payments are non-refundable. Students may
attend a make up class if applicable and available. A minimum of 10 students is necessary in each class.
Student name:__________________________________________________ Age:___________ School:__________________________________________
Parent name:___________________________________________________
Address:________________________________________________________ City:_______________________________ State:_______ Zip:_____________________
Phone:____________________________ Cell:___________________________
Email:___________________________________________________________
Any special medical info to be aware of:________________________________________________________________________
In connection with registration for 2015 Summer Camp conducted by the Paramount Arts Center, I/we the undersigned acknowledge that I/we have been informed of
the activities to be offered and consent thereto, represent that child is in good health, physically fit and capable of participation in the arts programs and
performances to be offered; acknowledge the risks and hazards of physical injury inherent in these classes and hereby assume all such risks and hazards and I/we
hereby release, waive and agree not to assert against the Paramount Arts Center, its directors, teachers, officers, supervisors, agents or employees, any claim for
injury to child in consequences of or incident to such training, performance or other activities. In case of emergency, if the staff of the Paramount Arts Center
is unable to reach me/us by phone, or it is a situation that appears to require immediate emergency medical assistance, I hereby give my/our permission for the
staff to contact 911 and secure treatment for my/our child as named in the emergency information.
_____ I AGREE _____ I DO NOT agree to allow my child’s image to be used by the Paramount Arts Center for promotional use.
I have read the above and agree to its content.
Name of Parent/Guardian (please print):________________________________________________________________________
Nonprofit
Organization
U.S. Postage
PAID
Ashland, KY
Permit #70
Paramount Arts Center
1300 Winchester Ave.
Ashland, KY 41101
The Kentucky Arts Council, the State arts agency, supports the Paramount Arts Center with
state tax dollars and federal funding from the National Endowment for the Arts. Support is
also provided by the Paramount Woman’s Association and private donations. Governed
by ther Board of Directors, the Paramount provides all services, programs and activities equally
without regard to race, color, religion, national origin, age or disability and is an equal
opportunity employer. Programs and facilities are accessible to the disabled. Services include
audio description for the blind and low visioned, hearing amplification equipment and deaf
interpretation, wheelchair access and seating. Please make requests two weeks prior to performance.
CURRENT RESIDENT or
Signature of Parent/Guardian:__________________________________________________________________________________
Discounted prices apply to registration completed PRIOR TO MAY 15. After May 15 regular prices
apply. Camp size is limited and your payment reserves your space. Full payment is due with registration.
AFTER MAY 15
WEEK I
Jungle Moves
Acting from the Ground Up
Jewelry Making
Arts Sampler
Production Camp:
Legally Blonde the Musical
WEEK II
Barnyard Dance
Drawing
Modeling
Out of this World
Drawing With Color
Nature Art
All that Jazz
_____$60
_____$85
_____$100
_____$85
_____$85
_____$110
_____$125
_____$110
_____$375
_____$425
_____$60
_____$85
_____$95
_____$95
_____$85
_____$95
_____$85
_____$85
_____$110
_____$120
_____$120
_____$110
_____$120
_____$110
WEEK III
Ashland’s Top Junior Chef
Tie-Dye Party
Dancing through Time
Painting With Oils
Flying Origami
Let’s Go Camping
Angelina Ballerina
Production Camp: Alladin Kids
_____$100
_____$100
_____$85
_____$95
_____$85
_____$85
_____$85
_____$375
_____$125
_____$125
_____$110
_____$110
_____$110
_____$110
_____$110
_____$425
WEEK IV
Lego Robotics
Storybook Art
Playwriting
Hip Hop
Sign Language and Singing
From Caterpillars to the Caribbean
_____$85
_____$85
_____$85
_____$85
_____$85
_____$85
_____$110
_____$110
_____$110
_____$110
_____$110
_____$110
The Paramount believes that classes and workshops should be open to everyone
regardless of their financial status. The Paramount offers a limited number of
partial sholarships based on financial need. For a scholarship application
please contact the Education Department at 606.324.3175 ext. 311
Cancellation Policy: PAC makes every effort to maintain the schedule of
summer camps as announced in the brochure. However, we reserve the right to
cancel any camp not meeting a minimum enrollment. Camp cancellations are
decided one week before the class begins. Fees are 100% refundable if PAC
cancels a camp due to insufficient enrollment.
Refunds and Credits: Cancellations made by the student or parent before the
start dates are 100% transferable to other camps if space permits. No refunds
will be made once tuition is paid. Camp fees are non-refundable.
Pay via checks made payable to Paramount Arts Center:
1300 Winchester Ave.
Ashland, KY 41101
Or by Credit Card:
Name (on card):______________________________________________________
Card Number: ________________________________________________________
Expiration Date: ______________________
CVC Code (3 digits on back)_________
AMOUNT ENCLOSED: ________________________________________________
Signature:____________________________________________________________
Due to staff and student allergies, the PAC summer camps are a peanut free zone!
SUMMER CAMP
2015
Summer Camp Open House Tuesday, June 2 at 6 PM
Meet instructors, learn how the camp day flows and tour the Paramount and Ashland
Regional Dance classroom space..
Early Bird Discount If Payment is Received by May 15