VA Summer Camp Waitlist Summer Camp is Full! We are currently only accepting registrations for our waiting list. No payment is required today. We will contact you if a spot opens up! I. Student Information 1. Student Name (First, Middle, Last) * 2. Gender * Select Gender… Female Male Non-binary Prefer not to say 5. Birthday * 3. School Name * 4. Grade (Entering Fall 2026) * 6. Age (as of June 30, 2026) * 12. Student’s Home Phone * 8. Student Street Address * 9. Town/City * 10. State * 11. Zip Code * II. Parent / Guardian Information 14. Parent/Guardian Name (First, Middle, Last) * 21. Cell Phone * 19. Home Phone 20. Work Phone 22. Email Address * 15. Parent Street Address (If different from student) 16. Town/City 17. State 18. Zip Code 23. Occupation 24. Employer III. Medical & Emergency Details 27. Does your camper have any behavioral or emotional issues the staff should know about? * If none, please write “None”. 28. Is your camper taking any medications to treat these conditions? * If none, please write “N/A”. [Standard] Known Food or Airborne Allergies * Crucial for snack time and lunch periods. If none, write “None”. [Standard] Emergency Contact Name Someone other than primary parent/guardian. [Standard] Emergency Contact Phone IV. Program Selection 7. Please select your child’s age group program: * Ages 7 & 8 — Monday to Friday (9 AM – 4 PM) Ages 9 & 10 — Monday to Friday (9 AM – 4 PM) Ages 11 & 12 — Monday to Friday (9 AM – 4 PM) Ages 13 & 14 (Advanced Application) — Monday to Friday (9 AM – 4 PM) The advanced art camp is for children with previous experiences with visual art and/or theatrical performances. Students will be accepted into this program based on their intent to begin focused art & theatrical instruction. Current instructors and camp directors will be making the final selections. What past classes or learning situations has your child participated in the realm of visual art or theatrical performances? * Your child should write a brief summary of their personal goals for the camp and list media or theatrical production elements they are most interested in participating in. * 13. Assigned T-Shirt Size * Select an official shirt size… Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large V. Legal & Consent 25. Photo & Media Release * This parental/guardian consent form is to both inform you and to request permission for your child’s/children’s photo/image and/or name to be published on the Vallejo Center for the Arts website and/or social media sites. By granting permission, I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Vallejo Center for the Arts. I GIVE PERMISSION for my child to be photographed during the Vallejo Center for the Arts Camp activities. I DO NOT GRANT PERMISSION for photos/images or my child’s name to be published on ANY public online place affiliated with or operated by VCA. 26. Transportation Authorization * I hereby give permission for the transportation of my child for official Vallejo Center for the Arts Camp activities by modes of transportation agreed to by the camp organizers. Important Camp Documentation Summer Camp Rules & Regulations I have read and agree to the documentation provided above. * Registration Status * Waiting List Only — Camp is currently full. Submitting this form adds you to our waiting list. We will contact you if a spot opens up. No payment is required today. Join Waiting List You will be redirected securely upon successful submission. Ensure all required fields (marked with a red star) are complete before clicking submit.