2022 SCDA Summer Theatre Camp Registration Form

Summer 2022 Outdoor Theatre Camp Registration Form

June 13th—24th from 9:30am-2pm - Mondays through Fridays
CAMP REGISTRATION FEES

Full Camp Registration Fee is $450.00. This includes a camp t-shirt, props, and crafts as well as the costumed performances we will give at the end of two weeks. If you would like to pay the full registration, please do so at the bottom of this form. If it is easier to pay a registration deposit of $150.00 you can select that option and pay the remainder between now and May 30th.
THEATRE CAMPER INFORMATION
Camper Name

First NameLast Name
Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information
First NameLast Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Type a question
Does your student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is your student prescribed any medications they need to have on hand or need to take during camp? If yes, please explain any instructions.
COVID

This year, due to covid restrictions, we will be holding our summer theatre camp outdoors. Campers will be asked prior to each day to check in and make sure they are well and coming from well households. The week before camp, campers will be sent a covid release to be brought with them to the first day of camp.
Who else can pick up your student? Please provide name, relation-ship to student, and contact phone
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Santa Cruz Drama Academy during camp. In exchange for the acceptance of said child’s candidacy by SCDA, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless SCDA and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Santa Cru Drama Academy including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities.
Medical Release and Authorization

As Parent and/or Guardian of the above named student, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the Santa Cruz Drama Academy and its affiliates including Directors, Teachers, and Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered camp.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature

Clear
T-SHIRT SIZE FOR CAMPER

Youth Small t-shirtYouth medium t-shirtYouth large t-shirtYouth XL t-shirtAdult small t-shirtAdult medium t-shirtAdult large t-shirtAdult XL t-shirt
REGISTRATION FEE
prevnext( X )
Total Camp Cost$450.00
Our two-week theatre camp costs $400.

Registration Deposit$150.00
If you would like to pay a deposit today rather than the full fee, please select this option. We will send you a reminder of the balance that must be paid by May 30th.

Extra camp t-shirt (either for student or family member)$15.00

QuantityT-Shirt

Total $0.00
Should be Empty:

Summer 2022 Outdoor Theatre Camp Registration Form

CAMP REGISTRATION FEES