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Creative Writing Workshops for Kids!Creative Writing Workshops
for Kids!Creative Writing Workshops for Kids!Creative Writing
Workshops for Kids!
Presented by Childrens Author
Bernae Okegbenro and Enrichment Reading
Learn how to create a memorable character, develop a storyline
and
recognize the different character types presented in best
selling moviesand literature. Discover the behind the scenes look
at becoming an authoras Bernae shares examples from her own books
and never before seenrough draft copies!
Class Schedule
Saturday, February 27th 11:00am-3pmGrade Level: 2nd 5th
Location: Atlanta-Buckhead Library
260 Buckhead Ave NEAtlanta, GA 30305
Friday March 5th 4:30-8:30pmGrade Level: 2nd 5th
Location: Hobby Lobby3001 Chapel Hill Rd
Douglasville, GA 30135
Saturday, March 20th 11:00am-3pmGrade Level: 2nd 5th
Location: Villa Rica Library(Villa Rica Branch)
70 Horace Luther DriveVilla Rica, GA 30180
Cost per workshop: $50Lunch or Dinner Provided
Seating is limited
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Registration Form
Childs Name:_______________________________________________
Date of Birth:____________________ Grade: _________
Age:_______
Parent/Guardian:
____________________________________________
Address: __________________________________________________
Phone: ________________________ Cell:
_______________________
Email: ____________________________________________________
I am registering for (circle): Feb 27th March 5th March 20th
HEALTH HISTORY OF CHILD: This is kept confidential.Attach
additional sheet if necessary
Please list any allergies:
_______________________________________
_________________________________________________________
Describe your childs allergic reaction:
____________________________
_________________________________________________________
Other medical concerns:
______________________________________
_________________________________________________________
Medications being used:
_______________________________________
_________________________________________________________Please
note that Enrichment Reading Publishing Staff cannot dispense any
medications. Do not send any
medications to class with your child.
Does your child wear: glasses ( ) contact lenses ( ) hearing aid
( ) corrective
shoes ( ) prosthesis ( )?
Any other info concerning your childs health that we should be
aware of:
_________________________________________________________
Emergency Contact Information:
Name:________________________ Relationship:
__________________
Phone: ____________________________________________________
In the event that neither I nor my designee cannot be contacted
at the time of a
medical emergency, I consent to emergency treatment determined
necessary by a
qualified physician.
Preferred Medical Facility _____________________________
(optional)
Parent/Guardian Signature: _____________________ Date:
__________
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Authorization and ConsentAs parent, legal guardian or agency
representing the child named above, I hereby give consent to enroll
my child in
the specified program(s) operated by Enrichment Reading Staff. I
recognize that my child must follow safety
instructions, remain in areas designated by staff, and refrain
from behavior that is harmful to h im/her or others.
Failure to do so will result in dismissal from program without
refund. The Enrichment Reading staff will do its best
to ensure a safe experience, however I understand that accidents
do occur. I hereby release The Enrichment
Reading Staff from any and all responsibility and liab ility of
any nature resulting in my childs participation in any
program accident including claims for any injury, illness,
death, loss or damage. My signature gives permission to
use all photos and videos taken during programs for promotional
purposes. To opt out of this, I will submit request
in writing. I have informed camp staff of my childs medical
conditions. All information given is accurate and trueto the best
of my knowledge.
Parent/Guardian Signature: ________________________________
Date: __________
PAYMENT INFORMATION:
Method of Payment: MasterCard Visa Check (make payable to
Enrichment Reading)
Total Amount Enclosed:______________________ Check#:
_______________
CC# _______________________ Exp Date _________ Security Code
_______
Name on Card:
____________________________________________________
Billing Address:
___________________________________________________
________________________________________________________________
Charge by phone: Call 678-522-8838
Mail Registration Form and Payment to:
Enrichment ReadingAttn: Bernae OkegbenroPost Office Box
1364Villa Rica, GA 30180
You will receive email or phone confirmation within one week of
your registration.If you are not notified within one week, please
email or call Bernae Okegbenro [email protected] or
678-522-8838.
