The Drama Club Fall 2021
Visit www.thedramaclubpa.com for full camp descriptions. Payment may be made by Venmo @Andy-Theodorou or on this form through PayPal. You may also pay via Square on our site.
Parent/Guardian Name
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First Name
Last Name
Email (please CONFIRM and use an account that you check regularly, we will use this for all updates)
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Confirmation Email
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Phone Number
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Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
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Postal / Zip Code
Student Name
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First Name
Last Name
Student Birthdate
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Month
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Day
Year
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Emergency Contact 1
First Name
Last Name
Emergency Contact 1 Phone Number
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Area Code
Phone Number
Emergency Contact 2
First Name
Last Name
Emergency Contact 2 Phone Number
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Area Code
Phone Number
People Granted Permission to Pick up Student
Allergies/Health Issues
T-Shirt Size
What Program(s) would you like to register for?
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Grade 1-3 Fall Program
Grade 4-6 Fall Program
Grade 7-12 Fall Program
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Payment for 1 Program
$
225.00
Full payment for fall program
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0.00
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