Please fill out the application below. Send it and your check to the address at the bottom. A confirmation and registration/info packet
will be sent to you OR print from links below.
99 Drums Application
(please print all information & feel free to duplicate this form)

Name_________________________________________

Age_______ Male_______Female_______

Parent/Guardian_________________________________

Address________________________________________

City, State, Zip__________________________________

Phone (work)_____________ (home)______________

Phone (cell)______________ e-mail_________________

If you DO NOT wish parent/guardian name to be added to our Accessible Arts mailing list please check here _____

Dietary restrictions______________________________

Name of requested roommate_____________________

List disability and special needs related to visual impairment, mobility, developmental, mental or other disabilities (see note on previous page)
______________________________________________

______________________________________________

Early registration by April 15th:
_____ (# of children) x $55 = _________
_____ Enclosed is my letter requesting a scholarship
(letter must arrive before April 15th)
Registration after April 15th:
______ (# of children) x $75 = _________
Registration after April 23rd:
______ (# of children) x $100 = _________
on a space available basis.
(Release forms are available below. Release forms must arrive by April 26th.)
Please send this form and your check payable to
Accessible Arts, Inc., 1100 State Ave., Kansas City, KS 66102
Please fill out the following forms carefully and return them by mail or email attachment. We must have them with your signature before camp begins, and MUCH PREFER to have them several days in advance.
Back to 99 Drums ~ Link to Parent Cover Letter ~ Link to Medical Release
Link to Liability Release ~ Link to Schedule/What to Bring ~ Link to Directions and Map