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SUMMER CAMP REGISTRATION

PARENT'S CONTACT INFORMATION

1. Parent's First name*

1. Parent's Last name*

2. Parent's First Name*

2. Parent's Last Name*

Email*

Phone*

STUDENT'S #1 INFORMATION

MEDIA RELEASE

From time to time, we capture photos and videos during our classes to showcase student creativity, highlight learning experiences, and promote our programs through flyers, websites, and social media.

Please review the information below and select your preferred option regarding the use of your child’s image.

MEDIA RELEASE (CHOOSE ONE)*

YES, I give permission for my child to be photographed or recorded during class or program-related activities. I understand that these images or videos may be used in promotional materials, websites, social media, or other educational-related platforms.

NO, I do not give permission for my child to be photographed or recorded during class or program-related activities. I understand that staff will ensure my child is not included in any media content.

School Name*

Child's First Name*

Child's Last Name*

Grade*

Age*

Any Allergy's*

Be prepared to present your I.D. at the time of pick up.

CHOOSE A CAMP*

JUNE 1ST-5TH

JUNE 8TH-12TH

JULY 6TH-10TH

JULY 13TH-17TH

CHOOSE YOUR PACKAGE (Student #1)*

EARLY BIRD:FULL WEEK CAMP $30 OFF

EARLY BIRD:FULL WEEK CAMP $30 OFF$315

EXTENDED CARE: EARLY DROP-OFF

EXTENDED CARE: EARLY DROP-OFF$40

EXTENDED CARE: LATE PICK-UP

EXTENDED CARE: LATE PICK-UP$60

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP$100

STUDENT #2 INFORMATION

Child's First Name #2

Child's Last Name #2

Grade

Age

Any Allergy's

CHOOSE A CAMP

JUNE 1ST-5TH

JUNE 8TH-12TH

JULY 6TH-10TH

JULY 13TH-17TH

CHOOSE YOUR PACKAGE (Student #2)

EARLY BIRD:FULL WEEK CAMP $30 OFF

EARLY BIRD:FULL WEEK CAMP $30 OFF$315

EXTENDED CARE: EARLY DROP-OFF

EXTENDED CARE: EARLY DROP-OFF$40

EXTENDED CARE: LATE PICK-UP

EXTENDED CARE: LATE PICK-UP$60

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP$100

SIBLING DISCOUNT: additional child 50% OFF

SIBLING DISCOUNT: additional child 50% OFF$172.50

STUDENT #3 INFORMATION

Child's First Name #3

Child's Last Name #3

Grade

Age

Any Allergy's

CHOOSE A CAMP

JUNE 1ST-5TH

JUNE 8TH-12TH

JULY 6TH-10TH

JULY 13TH-17TH

CHOOSE YOUR PACKAGE (Student #3)

EARLY BIRD:FULL WEEK CAMP $30 OFF

EARLY BIRD:FULL WEEK CAMP $30 OFF$315

EXTENDED CARE: EARLY DROP-OFF

EXTENDED CARE: EARLY DROP-OFF$40

EXTENDED CARE: LATE PICK-UP

EXTENDED CARE: LATE PICK-UP$60

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP

EXTENDED CARE: EARLY & LATE DROP OFF & PICK UP$100

SIBLING DISCOUNT: additional child 50% OFF

SIBLING DISCOUNT: additional child 50% OFF$172.50

AUTHORIZED STUDENT PICK UP

1. Authorized Parent Pick-up Name*

1. Authorized Parent Pick-up Contact #*

2. Authorized Parent Pick-up Name

2. Authorized Parent Pick-up Contact #

3. Authorized Parent Pick-up Name

3. Authorized Parent Pick-up Contact #

INTERESTED AND WOULD LIKE MORE DETAILS?

INTERESTED AND WOULD LIKE MORE DETAILS?*

Spring Break Classes

Summer Camp Classes

Weekend Enrichment

Rental Space

Monthly Newsletter

Not Interested

ANY QUESTIONS

Any Questions or Comments?

COOL GRADIENT IDEA FOR FLYER HHH.jpg

CONTACT US

8141 Long Point Rd, Suite #36,

Houston, TX 77055

Call Us: (832) 660-5879

HealthyHipHopBOOKINGS@gmail.com

Healthy Hip-Hop provides high-quality Creative Arts Services that connect communities through creativity, community, and self-expression.

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