Mud Slingers Pottery & Glass Studio 704-796-1600/704-786-3359

 

   

 

 

           2010 Clay Camp for Kids

                                          

Week 1 - Monday, June 21– Friday, June 25, 2010                 Cost -- $100.00 per child

Week 2 - Monday, July 19 - Friday, July 23, 2010

Week 3 – Monday, August 2 – Friday, August 6, 2010                                   

Please Print

 

Week you are registering for:  _________________________________________________________

 

Student’s Name:  __________________________________________________________________

 

Student’s Age:    ________

 

Parent’s Name(s):  ________________________________________________________________

 

Mailing Address:  _________________________________________________________________

 

Home Phone:  ________________ Work Phone: _________________ Cell phone: ______________

 

E-mail Address:  __________________________________

 

How did you hear of Mud Slingers?____________________________________________________

 

In case of emergency, Mud Slingers should contact:

 

Name:  ________________________________________________ Phone #__________________

 

I understand that every precaution is taken to secure the safety of each student; however, in case of an accident, I agree to release Mud Slingers from any liabilities.

 

Signature ______________________________________________Date:  _______________________

 

Make check payable to Mud Slingers Pottery.  Send to 9 Union Street North, Suite 150, Concord, NC  28025

Contact:  Rachel Rogers – 704-796-1600

 

Additional Registration Forms may be picked up at Mud Slingers Pottery