Circus Camp 2008

Print and fill out the below form, send to
Open Hand Theater 518 Prospect Avenue, Syracuse, New York 13208
or call us ~ 315-476-0466

Name(s): ______________________________________________________________
Address: _______________________________________________________________
School: ________________________ Age:_______________ Grade fall 2008_________
Parent Name: ____________________________________________________________
Parent Phone: _______________________Parent Email: __________________________
(Please circle preferred method of contact)

Please enroll in:
Session I ( July 7 – July 18 )
Or / And
Session II ( July 21 – August 1 )

T-shirt size:
Child: - S , M, L / Adult: - S, M , L , XL
(additional T-shirt orders $10 each)

Any Special Needs ?:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Tuition: $ 300.00 (Circus T-shirt included)
Deposit: ($100 non-refundable deposit required)____________
Balance due:$___________

Please pay by:
Check - Please make checks payable to Open Hand Theater, Inc.
Credit Card #__________________________Exp. Date____/____/_______