Registration form for Camp KREATIV 2017

14-19th August 2017

The Sooriya Music Village, #49, Skelton RD, Colombo 5

(Please complete & email to info@powerofplay.lk by 11 th August 2017 – limited space/first come, first served basis.

IMPORTANT: I. Please ensure accuracy of spellings and details on this form as it will be the base for all information

required for Camp KREATIV ’17 literature and communications.

PERSONAL INFORMATIONName

Gender (Please Circle) 1. Male

2. FemaleAge

Current school and grade

PARENT/GUARDIAN INFORMATIONName

Contact number

Email

Name and relationship of individual authorized to drop off/pick up participant from workshops & his/her contact number:

Workshop Information and FeesCAMP FEES (LKR per participant for the entire week )-

4-6 age group : 1 to 2 workshops with 1 snack = 9250/= 3 or more workshops with 1 snack and lunch

= 13,500/=

7 to 12 age group: 1 to 2 workshops with 1 snack = 9250/= 3 or more workshops with 2 snacks and lunch

= 14,250/=

As CK ’17 is based in a restaurant please note that outside food is not allowed. Please refer the menu for full snack and meal details. Please note that additional meals and snacks can be added to the above at the following rates:

Cost per snack : 250/= Cost per lunch : 350/=

PLEASE check the CK detailed schedule to;

- Ensure you select a combination of workshops that do not have conflicting times.

- Note how many sessions your workshop(s) include(s). Fees are quoted for all sessions within the workshop(s).

- Attendance for all sessions within the workshop is mandatory.

Participating Workshops (Please highlight/circle)

4-6 years (Total workshops – 4) Discovery through play – by Seema Omar and

Tehani Chitty (This mixed medium session counts as 2 workshops due to duration and variety of activities)

Dance : Exploring rhythm and movement – by Imesha of the Chitrasena School of Dance

Drama : Let’s tell fantastic stories – by Sulochana Dissanayake

7-12 years (Total workshops – 5) The Art of Photography – by Chamila

Karunarathne (10-19 years) Robotics : Igniterspace Yourng Innovator - by

Igniterspace Drama : Let’s tell fantastic stories – by

Sulochana Dissanayake Girls, Boys and our bodies – by Subha

Wijesiriwardena Musical Comedy: Sights, Sounds, Stories – by

Larry T Hill Dance : Exploring rhythm and movement – b

Imesha of the Chitrasena School of Dance

TOTAL Payment for CK ‘17 LKR.

Please note that full payment (non-refundable) must be received by CK by 11th August 2017 to confirm registration.

Preferred payment method (Please circle) I. Direct DepositII. Cash payment

DIRECT DEPOSIT;

- Bank A/C Name – Power of Play (PVT) LTD- A/C # - 1117010105- Bank & Branch – Commercial Bank, Pita-Kotte

Please email deposit receipt to info@powerofplay.lk

CASH PAYMENTS;

- 8am-9am on Monday August 14th 2017 at Sooriya Village.

Accurate change will be much appreciated.

Once payment is received, registration will be confirmed via email & SMS. All payments are non refundable.I HAVE READ AND AGREE WITH THE TERMS AND CONDITIONS STATED IN THE CK GUIDELINES FOR 2017 YES

NO How did you hear about CK 2017? (Please Circle) CK 2014/15/16 Participant

Facebook Email Posters/Flyers – specify location

………………………………. Other – please specify

…………………………………….Thank you and see you at Camp Kreativ 2017!