Lunch Special

Summer Camp Lunch Special

• Are you a member of the Holter Museum of Art?*
  • Yes
  • No
• Camper's Name* First Last
• Parent-Guardian's Name* First Last
• Edu: Summer Camp Lunch Special Price: Member
• Edu: Summer Camp Lunch Special Price: Non-member
• Parent-Guardian's Email*
• Parent-Guardian's Phone Number*
• Second Parent-Guardian's Name First Last
• Second Parent-Guardian's Contact Information
• AllergiesIf camper has allergies describe all allergens, all allergic reactions and any medication (i.e. epipen, benadryl) that need to be administered.
• Physical / Medical ConditionsDoes the participant have any physical or medical conditions that could result in an emergency or preclude them from engaging in certain activities?
• MedicationsPlease list all medications (including over-the-counter or nonprescription drugs) taken routinely.
• Total $0.00
• Contact Email*
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• Credit CardCard Details Cardholder Name