Art Camp #4 (021)

July 6 - July 10
1 - 4 pm
Half-day, one week
$165/Members: $145

*	Student Name:
*	Address:
	Address (cont):
*	City:
*	State:
*	Zip Code:
*	Phone:
	Work Phone:
	Cell Phone:
*	Email:
	Referred by:	Who referred you to classes at KIA?

*	Price:	$145.00 Members $165.00 Non-Members

*	Notices:	I hereby consent that the KIA may photograph me for publicity purposes I have read the KIA's class registration policy.