Birthdate:    Completing Grade in the spring of 2008
                      mm/dd/yyyy
Male 
Female 

Father:           Mother: 
Work Phone:             Work Phone: 
E-Mail:            E-Mail:
Business Profession of Mother and Father:  

Sibling(s): name and age:

Applicant Contact Information: 
Please fill in the address here where you (the applicant) would like to receive mail.  
Street Address #1
Street Address #2
City   State (abbr.) Zip
Country (if outside U.S..)

Home Phone:    Home Fax: 
E-Mail:   
       

Please note billing address if it is different than mailing address:

       
How did you learn about MexArt?  

Art or Dance Interests:

Name of Current School:

After-school or Extra-curricular Activities:

Spanish Fluency: None  1 yr of school  2 yrs of school  3+ yrs  fluent

ESSAYS: This essay is very informal and is merely a way for our administrative staff to get a feel for who you are. DO NOT STRESS! You are not being graded here. Have fun with it.

1. Describe why you want to participate in this program and what you hope to gain from the experience.

Conditions and Terms of Enrollment

By submitting this on-line registration, I understand and agree to all MexArt policies terms, and conditions of enrollment, including the following:

A $750.00 non-refundable deposit must accompany this registration form to guarantee a space for a participant. The balance of fees for summer high school sessions are to be paid in full by April 15, 2008 or cancellation of enrollment will result. The balance of fees for semester high school students is due by November 15.  Students enrolling after these payment dates must make the payment in full at the time of enrollment. College student balances are due in full 15 days prior to session start date.  MexArt reserves the right to dismiss disruptive or abusive participants or participants who show signs of physical or emotional difficulties that MexArt does not feel capable of handling. There will be no refunds issued for early departure related to disciplinary problems, health, or family emergencies. Tuition insurance is available for those who worry early departure may occur.

I hereby authorize any physician selected by a MexArt director to order x-rays, routine tests, and other medical treatment needed for the health of my child. In the event that I cannot be reached in an emergency, I give permission to the physician selected by the director to hospitalize, secure proper treatment, and to order injections, anesthesia, and/or surgery for my child (myself, if adult).

Permission is granted to MexArt, with no additional charge, for the use of photographs, video tapes, or written work of participants for promotional purposes or MexArt mailings after the season ends. I also give permission for my contact information to be printed in a participant-staff directory.

Note: This information may be shared with the camper's counselors and/or camp nurses and otherwise is considered confidential.  

Additional comments about your interests, special family situations, etc.  

Any behavioral or social problems at home, school, or a past summer programs that we ought to be aware of?  

Any medical problems? What prescribed medications, if any, are you taking regularly?  

Are you a vegetarian?  (Vegetarians and non-vegetarians are welcome)
Yes  
No  

MexArt Costs:

MexArt will arrange to pick up all arriving participants from Mexico's Leon airport. All flights must arrive within a particular window of time.

Payment:  MexArt will only reserve a space for a participant when payment for the deposit has been received. MexArt accepts checks in U.S. currency only. Please make checks payable to MexArt. Cancellation of enrollment results if payment of the balance is not received by the payment due dates listed above in the section of Conditions and Terms of Enrollment. Students Enrolling after these due dates must make the payment in full at the time of registration.

Mail checks to :
Carly Cross 
9902 Crystal Ct. #107  BC-2323
Laredo, TX  78045