Summer Workshop Registration Form

Are you or your child a current MEMBER at Sun Prairie Media Center? (MEMBERS have paid the annual membership fee, NON-MEMBERS have not paid the annual membership fee). Membership information is available online: http://www.kids4.tv/memberships/. Memberships are renewed on a yearly basis. Please contact the staff at the media center if you have further questions. *

YES, I am a member and understand my workshop fee is adjusted to the member price
NO, I am a non-member and understand my workshop fee is full price

Adventures in Animation, Session 1 (Ages 9-14, Min 6 / Max 8, June 24-27, 9am-12pm)

*FULL: Please add to Waitlist: Member Cost: $100 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $140 (do not submit payment)

Adventures in Podcasting (Ages 9-14, Min 6 / Max 8, July 8-9, 1:30-4:30pm)

*FULL: Please add to Waitlist: Member Cost: $70 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $90 (do not submit payment)

Adventures in Live Television (Ages 11-14, Min 8 / Max 10, July 15-16, 1:30-4:30pm)

*FULL: Please add to Waitlist: Member Cost: $70 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $90 (do not submit payment)

Adventures in Animation, Session 2 (Ages 9-14, Min 6 / Max 8, July 22-25, 9am-12pm)

*FULL: Please add to Waitlist: Member Cost: $100 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $140 (do not submit payment)

Adventures in Movie Making, Session 1 (Ages 9-11, Min 6 / Max 8, July 29-Aug 1, 9-12pm)

*FULL: Please add to Waitlist: Member Cost: $100 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $140 (do not submit payment)

Adventures in Movie Making, Session 2 (Ages 11-14, Min 6 / Max 8, July 29-Aug 1, 1:30-4:30pm)

*FULL: Please add to Waitlist: Member Cost: $100 (do not submit payment)
*FULL: Please add to Waitlist: Non-Member Cost: $140 (do not submit payment)

Adventures in Animation, Session 3 (Ages 9-14, Min 6 / Max 8, July 22-25, 1:30pm-4:30pm)

Member Cost: $100
Non-Member Cost: $140

Child's Name *

First

Last

Child's Age *

Parent/Guardian, Name *

First

Last

Address: *

City: *

Zip Code *

Parent/Guardian, Phone Number: *

Parent/Guardian, Email *

Emergency Contact *

First

Last

Emergency Contact, Phone Number *

Please list any food allergies or special accommodations:

Please comment with any concerns or questions:

Payment method: (online payments include a convenience fee of 2.35% for credit cards and $1.00 for an e-check) *

Mail check to: Sun Prairie Media Center, 1350 Linnerud Dr, Sun Prairie, WI 53590
Pay with credit card or e-check online at: https://paydirect.link2gov.com/cityofsunprairieVT/ItemSelection/SelectItems
Pam Steitz Scholarship (available for those who qualify): https://www.kids4.tv/pam-steitz-scholarship/
*Waitlist: DO NOT submit payment at this time.

OPTIONAL: Donation to Pam Steitz Scholarship

The Pam Steitz Scholarship supports KIDS-4 enrollment fees for qualifying students. Please add your donation amount to the fee total when submitting payment.