Camp Canterbury 2023 Enrollment Form

Thank you for choosing Camp Canterbury this year! We know you have many options when selecting a summer program for your child.

A few quick notes to keep in mind:

This form is for those on scholarships or who have made payment arrangements by check.
Camp hours are 9:00 AM to 4:00 PM.
Before and after care is available for an additional $50.
If you are interested in scholarships, or alternate payment arrangements, please email Susan Pendergraft at Susan@CanterburyOKC.com or call us at
(405) 232-7464 prior to completing this form.

Primary Parent Information

This should be the parent/guardian that the student primarily resides with.

First Name

Last Name

Phone Number

Address Line 1

Address Line 2

City

State

ZIP Code

Would you like to place a second parent/guardian's information on file?

YesNo

Secondary Parent Information

First Name

Last Name

Phone Number

Does this parent reside at the address previously listed for the primary parent?

YesNo

Secondary Parent Address

Address Line 1

Address Line 2

City

State

ZIP Code

Student Information

Student First Name

Student Last Name

Student's Cell Phone (if applicable)

Student's Birthdate

Student's Grade in Fall 2023

School Student Will Attend in Fall 2023

Student's T-Shirt Size

I will require before and/or after care, at an additional cost of $50 for the entire week. Before care begins at 7:30 AM, and after care ends at 5:30 PM. Regular camp hours are 9:00 AM to 4:00 PM.

YesNo

I allow my child to be released in and out of the building without a parent escort.

YesNo

This question is only applicable to students who have a sibling in 7th or 8th grade also attending Camp Canterbury. All other students are required to have a parent escort them in and out of the building. I allow my child to be released in and out of the building with their older sibling.

YesNoNot applicable

Please list any known allergies or other things we should know to care for your singer well.

Your student has multiple options for breakout classes this year; however, some classes may fill up faster than others. Please rank their preferences. For example, if your student's favorite option is Dance, select Dance as the First Preference. We will do our best to accommodate your selections in order of preference.

In Artful Music we will explore how music and art connect by learning about a composer and artist, then expressing the work by creating pieces of art through various mediums such as movement, paint, and sculpture.

How did you hear about Camp Canterbury?

One t-shirt is included in your child's tuition. Would you like to buy an additional shirt for $10?

YesNo

Please describe how you heard about us.

If you are interested in purchasing more than one additional t-shirt, please contact us to process your enrollment.

Additional T-Shirt Size

Media Permission

I give permission for my child to be photographed and videoed to be included on our organization website, social media or print media. (Your child can, of course, still participate in activities if you do not grant permission.)

YesNo

Participation Agreement

By typing your name below, you acknowledge and accept the risks of physical injury associated with your child's participation in music rehearsals and music-related classes throughout the day, including a concert to be held on Friday, June 9, 2023. Except for gross negligence on the part of the sponsor, the parent/guardian accepts personal financial responsibility for any bodily personal injury sustained during the activity. Further, the parent/guardian promises to hold harmless the sponsoring organization and its representatives for any injury related to the activity. If a dispute over this agreement or any claim for damages arise, the parent/guardian agrees to resolve the matter through a mutually acceptable arbitration process.

Parent's Name

Contact Information

© 2024 Canterbury Voices. All Rights Reserved.
Questions? Contact us at (405) 232-7464.

Canterbury Voices is a nonprofit that relies on donations from supporters like you! Help further our mission by chipping in today.

	Ukulele	Drumming	Dance	Theatre	Artful Music
First Preference
Second Preference
Third Preference
Fourth Preference
Last Preference