Children's Academy of Fine Arts, Inc.
2012-2013 Registration Form via Email

Important Information: Our 2012-2013 year begins on January 11, 2012. The schedule of the 2012-2013 year is available online at: cafakids.org
Should you need additional information please contact Leigh Slayback at 386-451-8087(cell).
Please leave completed form at music office Room 104 or mail to:
Children's Academy of Fine Arts, Inc. P.O. Box 291523, Port Orange, FL 32129-1523

Name of Child
Parent's Name
Address
Email Address
Home Phone - enter numbers only
Cell Phone - enter numbers only
Emergency Phone - enter numbers only
Emergency Contact Person's Name
Rising Grade
Age
Home School? type Y or N
School Attends?
Home School Address - if child is home schooled
I will need a scholarship - type Y or N I realize that if I am a student, I can participate in the music-a-thon to raise funds for camp.
TRANSPORTATION
Home School Address - if child is home schooled
I need van pick-up for my child at this address:
I need my child brought home in the afternoon to this address:
Parent's Signature - typing your name into this box consitutes your authorized signature:
Camper's Hobbies
Camper's Allergies
If you hae additional questions, please contact Leigh Slayback at 386-423-4868 or via Cell Phone at 386-451-8087.
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