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PD Day Camp: Art Attack | 31 March
This event has only 20 space(s) left. If you continue and register more than 20 people (including yourself ), the whole group will be wait listed. Or, you can reduce the number of people you are registering to 20 to avoid being put on the waiting list.
How many people are you registering?
*
1
2
3
4
5
6
7
8
9
10
Fill in your registration information on this page. You will be able to enter the registration information for additional people after you complete this page and click "Continue".
Please be aware of
our registration/cancellation policy
before signing up.
Your Registration Details
First Name
*
Last Name
*
Email Address
*
Phone
Country
*
- select Country -
Canada
Germany
United Kingdom
United States
Province
*
- select State/Province -
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Street Address
*
City
*
Postal Code
*
I hereby authorize any images of the registered participant and any media material created by the registered participant during Kitchener-Waterloo Art Gallery programs to be displayed on the Kitchener-Waterloo Art Gallery Website and social media platforms, and to be used for external media purposes including marketing campaigns and promoting our recreational programs. (For participants under legal age - guardians must agree or decline permissions)
Photo Permission
*
- select Photo Permission -
Yes
No
If you have a discount code, enter it here
Apply
Event Fee(s)
*
PD Day Art Camp
-
$ 60.00
Total for this participant
Credit Card
Card Type
- select -
Visa
MasterCard
Amex
Discover
Card Number
*
Security Code
*
Expiration Date
*
-month-
Jan.
Feb.
Mar.
Apr.
May
Jun.
Jul.
Aug.
Sep.
Oct.
Nov.
Dec.
-year-
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
My billing address is the same as above
Billing Name and Address
Billing First Name
*
Billing Middle Name
Billing Last Name
*
Street Address
*
City
*
Country
*
- select -
Canada
Germany
United Kingdom
United States
State/Province
*
- select State/Province -
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Postal Code
*
Child Registration Details
Child's first name
Child's last name
Child's pronouns
she/her/hers
he/him/his
they/their/theirs
Child's birth date
Child's grade
Please detail any health or emotional concerns, including allergies, that the Gallery should be aware of. Will your child be bringing any medication to the Gallery? Does he/she carry an EpiPen?
Medical notes
Please provide the parent(s)/guardian(s) name and telephone number
Parents/guardians
Emergency contact (name and telephone number) in the event that parent(s)/guardian(s) cannot be reached
Emergency contact
How did you hear about this program?
Referral
Review