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					Photo Fun 2011 v3b               3/23/11           1:43 PM        Page 1




                            REGISTRATION FORM                                                                                                                                                                                                                  WEEKLONG SESSIONS JUNE 27–SEPTEMBER 2                       Welcome to
              Please use one form per person. Photocopies accepted.
   Tell Us About You
                                                                                                                                                                                                                                                                                                                 Summer Photo Fun
   Child’s Name                                                                                                                                                                                                                                                     Summer                                         Camps for Kids
   (circle) M           F         Age               Birth Date          /      /




                                                                                                                                                                                                                    Camps for Kids
   Parent/Guardian Name(s)
   Address                                                                                                                                                                                                                                                                                                      at George Eastman House!
   City                                     State                                       Zip
   Daytime Phone
   Evening Phone
                                                                                                                                                                                                                                                                 Camps for Kids                                  Our weeklong photography-based
   E-mail Address                                                                                                                                                                                                                                                                                                 workshops run Monday-Friday,
   Emergency Contact                                                                                                                                                                                                                                                                                                    9 a.m. to 1:30 p.m.
   Emergency Contact Phone
   Museum Member (circle) Y                    N          Member ID#

   Choose Your Camp
   Ages 7–8
     Take It! Make It! . . . . . . . . . . . . . . . . . . . . . . . . . June 27–July 1
     Freaky Photos . . . . . . . . . . . . . . . . . . . . . . . . . . . Aug 29–Sept 2
   Ages 9–10




                                                                                               Rochester, NY 14607-2298
     Photo Fashion . . . . . . . . . . . . . . . . . . . . . . . . . . . July 11–15
     Digital Discovery . . . . . . . . . . . . . . . . . . . . . . . . July 25–29
     Darkroom to Digital . . . . . . . . . . . . . . . . . . . . . . Aug. 8–12
                                                                                               900 East Avenue




                                                                                                                                                                                                                     Summer
     On Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Aug. 22–26
   Ages 11–12
     On Location shorter week price – $20 off! . . July 5–8
     Darkroom to Digital . . . . . . . . . . . . . . . . . . . . . . July 18–22
     Digital Discovery . . . . . . . . . . . . . . . . . . . . . . . . Aug. 1–5
     Multimedia Madness . . . . . . . . . . . . . . . . . . . . . Aug. 15–19
   Total # of camps ____ x $120 per session
                           ($100 for 6/28 only)                                    $________                                                                                                                                                                                                                Experienced
   Member’s price:                                                                                                                                                                                                                                                                                          leaders will guide
        # of camps ____ x $110 per session
                           ($90 for 6/28 only)                                     $________                                                                                                                                                                                                                hands-on activities
                                     Total fees                                    $________
                                                                                                                                                                                                                                                                                                            in and around the
                                                                                                                                                       leading museums of photography and motion




                                                                                                                                                                                                    Monroe; and with private contributions from individuals,
                                                                                                                                                                                                                                                                                                            Museum, gardens
                                                                                                                                                       George Eastman House is one of the world’s
                                     (includes all supplies fees)


                                                                                                                                                                                                    George Eastman House is supported with public funds

                                                                                                                                                                                                    agency; the Institute of Museum and Library Services;
                                                                                                                                                                                                    from the New York State Council on the Arts, a State
                                                                                                                          About George Eastman House




                                                                                                                                                                                                    the National Endowment for the Arts; the County of
   Method of Payment                                                                                                                                                                                                                                                                                        and the grounds.
                                                                                                                                                       Located in Rochester, New York, on the
                                                                                                                                                       estate of the legendary Kodak founder,




     Check enclosed, payable to: George Eastman House
                                                                                                                                                                                                                                                                                                            Some camp programs also feature “explore the
     Credit Card (circle)  VISA MASTERCARD AMEX
                          Amount to Charge            $________                                                                                                                                                                                                                                             neighborhood” walking trips and “on-location”sites.
   Name on Card                                                                                                                                                                                                                                                                                             Cameras—digital and other kinds!—will be provided
                                                                                                                                                                                                    corporations, and foundations.                                                                          for each camper.
   Card Number
   Expiration                     3-digit security code (on back of card)
                                     Total fees charged to card                    $________                                                                                                                                                                        900 East Avenue • Rochester, NY 14607             Campers receive a
   Signature                                                                                                                                                                                                                                                                 www.eastmanhouse.org
                                                                                                                                                       pictures.




                                                                                                                                                                                                                                                                                                             take-home CD with all their creations
                                                                         continued on back
                                                                                                                                                                                                                                                                                                                    at the end of the week.

				
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