Camp Registration Form

Shanelle Gray Studios

Welcome to Make-a-Movie Camp!
Legal Name of child*

First NameLast Name
Age*
D.O.B *
Phone Number*

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name *

First NameLast Name
Mother or Father's name*

First NameLast Name
Emergency Phone Number*

Area CodePhone Number
MaleFemaleOther

Do you have an IMDB already?*
If so, tell us the name and one credit associated with your page*
If not-please write the name exactly as you would like it to appear on IMDB*
What date or dates are you requesting?*
PLEASE NOTE IF YOU DO NOT PROVIDE US WITH PROPER INFO FOR AN IMDB CREDIT FOR YOUR CHILD FOR MAKE A MOVIE CAMP,
YOUR CHILD WILL NOT BE CREDITED WITH AN IMDB CREDIT. IF WE
CREDIT THE WRONG NAME AND YOU DIDN’T GIVE CORRECT INFO
YOU WILL BE RESPONSIBLE FOR MERGING THE PAGES AND
FIXING THE NAME.

GETTING AN IMDB CREDIT IS HARD AND CAN ONLY BE DONE WITH A LEGITIMITATE CREDIT! WE ARE GIVING YOU A CREDIT BUT YOU MUST CLAIM YOUR OWN PAGE AND PAY FOR YOUR OWN ACCOUNT. WHEN WE SEND YOUR FILM, WE WILL SEND INSTRUCTIONS TO DO SO-SO YOU CAN ADD PICTURES TO THE ACCOUNT AND MAKE IT YOUR OWN.

THE FILMS WILL BE COMPLETED AT THE END OF SUMMER AND WE THINK YOU WILL LOVE THEM!

Our red carpet festival is October every year after Summer Camps where the film/films we made will be shown and everyone will be invited. This is an amazing event where your child will be the star. Please let us know if your child is in a band or does something special. We try to make this a night where the kids can perform! Red carpet, pictures and screening where all the kids get fun awards.

Thank you for choosing us for camp, as a small business we appreciate you.

-Shanelle
Health Portion:
The information you provide here will be held in the strictest confidence. This will be used for emergency only.
Doctor Name*
Doctor Phone Number*
Does the child have allergies*
If so, to what?*
Is your child on medication?*
If so, please let us know what kind. We are not allowed to administer but will work out how to make sure they get it. *
Does your child have anxiety?*
Is there anything you want to tell us about your child?*
Consent
To the extent allowed by law, I, the undersigned am the parent/guardian of the individual(s) named below, and shall hold harmless, indemnify and defend Shanelle Gray Studios and Shanelle Gray-Faulkner Inc, employees, volunteers and agents/outside service or contractor of each of them from and against any and all liability, loss, damage, expense, cost of every nature, and causes of actions arising out of or in connection with any negligence in the performance of this agreement. It is further understood and agreed that this waiver, release and assumption of risk to be binding on my heirs and assigns. I also release SGS, SGF Inc. and any representative associated with SGS and SGF, Inc. of liability for any claims that may arise out of activity-which includes driving. SGS/SGF Inc. also reserves the right to remove participants from the program for any reason. I hereby grant permission to SGS/SGF Inc. to take my child’s photo while participating in the activities to use for publicity.

All employees at SGS/SGF Inc. have been live scanned and FBI cleared and every person associated with camp the same.

I have read this entire Informed Consent Agreement. I fully
understand it and I agree to be legally bound by it.
Signature*

Clear
Payment Agreement
Signature

Clear
$550 per week of Make a Movie camp.

$100 off for siblings and/or a 2nd week

Cancellation policy:

4 weeks or more-Full refund (EXCEPT FOR NON REFUNDABLE DEPOSIT)

2 weeks or more-50% refund to be used for classes only

(EXCEPT NON REFUNDABLE DEPOSIT THAT IS LOST)

Anything under 2 weeks-NO REFUND OF ANY KIND

I have read this entire Informed Consent Agreement. I fully
understand it and I agree to be legally bound by it. $200 non refundable deposit will be charged upon any booking. This shall not come back to me in the event of any cancellation for any reason as this is an administrative fee.
Signature*

Clear
We cannot wait to work with you!!!
*Terms and conditions*

By signing this form I agree to be legally bound by the terms and conditions of the studio. I understand that my deposit is non refundable under any circumstances. I will not get this refund back in the form of cash, credit to the studio or any other way. I understand that if I cancel in 4 weeks or more I will get a refund except for my non-refundable $200 deposit. I understand if I cancel 2 weeks or more I will only get 50% of my money back ONLY in the form of a credit to the studio ONLY not in the form of cash or money back. I will also NOT get my non refundable deposit back at all. And if I cancel in under two weeks, I will not get ANY funds back at all with no credit to the studio. I will not get my $200 deposit back under any circumstances for any reason.
Should be Empty:

Shanelle Gray Studios

Health Portion:

Consent

Payment Agreement