Art and Culture CampREGISTRATION FORM

Dear Parent/ Guardian:

We are excited to announce a new arts and culture day camp being offered this summer at the Notre Dame Center for Arts and Culture (NDCAC). This camp is for middle school students: rising 5th through 8th graders.

There are two chances to have your child take part in Art Camp. The first eight day session will be held from June 24-July 3 and the second session will be July 22-31. Camp will be held weekdays from 9am-12p . Please indicate below your choice of session. A materials fee of $12.00 will be charged for the session. Make checks payable to Robinson Community Learning Center (RCLC).

Every day at camp we will focus on each individual student’s artistic ability and interests using smaller projects and a variety of artistic methods and materials, but we will also be focusing on creating works of art for the community to enjoy. Our theme this year is Civil Rights, and we will be focusing on the national and local events of 1963: the 50th anniversary of the Birmingham Church Bombing and Dr. Martin Luther King Jr’ s visit to South Bend and the University of Notre Dame. At the end of both eight day sessions, the students’ work will be compiled into a show and displayed in the community.

If you are interested in having your child participate, please complete and submit this form to NDCAC community program staff. Spaces are limited, so only the first 15 students per session will be admitted in the program.

If you have any questions about any of the information or would like some help with this process please do not hesitate to contact Jennifer Wittenbrink Ortega at 574-631-9432 or wittenbrink..1@nd.edu.

Thank you for your interest,Jennifer

Please print information clearly.

Student’s Name: ___________________________________________ Student’s Date of Birth: ______________________

Parent/Guardian Name: ________________________________________________________________________________

Please choose: _______________________ Session 1 (June 24-July 3) _____________________ Session 2 (July 22-31)

School: ______________________ Grade: 5 6 7 8 How did you hear about this? ____________________________

My student’s main language is: _________________________ Other languages spoken at home: ______________________

Address: _______________________________________________ City: ____________________ Zip: ________________

Phone: __________________ Cell phone: _____________________________ email: ____________________________

I wish to enroll my student in Visual Arts and Culture Camp at the Notre Dame Center for Arts and Culture. I understand I am responsible for all transportation to and from Camp. I will try and ensure that he or she will attend all sessions. I will keep all contact information up to date.

Parent/ Guardian Signature: _____________________________________ Date: ________________________

1045 W. Washington St.South Bend, IN 46601