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2021 VIRTUE-ALL PRESCHOOL REGISTRATION
How did you get connected with Summer Music + Arts Camp?
Virtue-All Music + Arts Camp 2020 family
Previous Summer Music + Arts Camp family
Saint Barnabas community member
Heard from a friend
Choose One Week Only
Summer Music + Arts Camp (ENTERING K+)
In-person camp for elementary aged children is full. Please visit www.saintbarnabas.org/camp-wait to join the waiting list.
Virtue-All Camp (PRESCHOOL ONLY)
Registration fees cover the cost of supply kit, daily Zoom sessions with Ms. Jo, 5 workshops, and a t-shirt for each camper.
1 camper = $35
2 campers = $70
3 campers = $105
Please contact us at firstname.lastname@example.org if you are in need of a scholarship. We do not want finances to keep anyone from participating in Summer Music + Arts Camp.
Please consider making a donation to our scholarship fund for Summer Music + Arts Camp.
Parent/Guardian Name (#2)
Address Line 2
District of Columbia
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Camp Hours Contact
Please provide the best contact person and phone number for camp hours (8:30-11:30am).
Relationship to Camper
There are no
Maximum number of campers reached.
Emergency Contacts and Authorized Pick Up Persons
List the individuals (if any) who are not parents that we may contact in an emergency and who you authorize to pick up your camper(s) at the end of a session.
There are no
Maximum number of contacts reached.
Agreement of Permission
As a parent or legal guardian of the child/children I am registering, I grant permission for my child/children to participate in Summer Music and Arts Camp and/or Virtue-All Camp 2021. I give permission for photography of my child to be used on the Saint Barnabas website, Facebook page, newsletter, and other printed/digital publications for no purpose except that of promoting the life and community of Saint Barnabas Episcopal Church. For preschool, I understand that if I do not want my child recorded in live Zoom sessions, I will be responsible for disabling the video function.
Yes, I agree.
I certify that by typing my name below in the Electronic Signature Field and submitting this form, I intend to sign this document and be bound to the same extent as if I had provided a physical signature.
Date of Birth
Date Format: MM slash DD slash YYYY
What grade is the child entering in Fall 2021?
Not yet in school
Indicate if your child has ever experienced or is being treated currently for any of the following:
Frequent Upset Stomach
Please indicate if your child has allergies to:
Please describe allergies in further detail:
Physical activity restrictions:
Child's current medications
All medicine(s) need to be properly labeled in original pharmacy container. Over the counter medication must also have the camper’s name written on the container.
Relationship to Camper(s)