Name: Holter Museum of Art
Address: 12 E. Lawrence St., Helena, MT, 59601, US
Telephone: (406) 442-6400

Missing Registration Form

Camper's Name*
First Last
Camper's Age*
Camper's Gender Identification
- Non-binary
- Female
- Male
- Trans
- Cis
- If you do not see an option here that fits your child's identification, please make a note under "Social Emotional Well-being"
Select as many as you would like!
Parent-Guardian's Name*
First Last
Parent-Guardian's Email*
Parent-Guardian's Phone Number*
Second Parent-Guardian's Name
First Last
Second Parent-Guardian's Contact Information
Camper's T-shirt Size

For More than a T-shirt summer camp.
Allergies
If camper has allergies describe all allergens, all allergic reactions and any medication (i.e. epipen, benadryl) that need to be administered. Please include any and all food allergies, including gluten free or other dietary restrictions.
Physical / Medical Conditions
Does the participant have any physical or medical conditions that could result in an emergency or preclude them from engaging in certain activities?
Medications
Please list all medications (including over-the-counter or nonprescription drugs) taken routinely.
Social Emotional Well-being
Is there anything else our instructors need to know about the participant that would help us provide the best experience for them?
REFUND Policy*
I have carefully read this agreement and understand it to be an acknowledgement on my part of the Holter Museum of Art's refund policy.
HOLTER MUSEUM OF ART EDUCATION PROGRAM POLICIES
Preregistration is required for all Holter educational programs. Full tuition will be refunded on any cancellation up to two weeks prior to beginning of class, after that 40% of tuition will be refunded upon cancellation.
Contact Email*

SC Holter Camp

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