MagikTheatreCampRegistration

WAITLIST: Magik Theatre Goes To Broadway

Please fill out the form below with your camper's information. In the event a space becomes available, this form will expedite the registration process.
Please select which camp you are interested in: *
Please select your camper's age group: *
Camper Information
Camper's Name*

First NameLast Name
Birth Date*

MonthDayYear
What are your camper's preferred pro-nouns?
Grade in the Fall*
Please select camper's t-shirt size
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information #1
Name*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number
E-mail*
example@example.com
Parent/Guardian Information #2
Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
E-mail
example@example.com
Emergency Contact Information

(other than parent/guardian information)
Emergency Contact*

First NameLast Name
Relationship*
Phone Number*
Alt. Phone Number
Please indicate in the space below, all persons authorized to pick up your camper, including guardians and emergency contacts.
Authorized Pick Up #1:   First Name*   Last Name*
Authorized Pick Up #2:   First Name   Last Name
Authorized Pick Up #3:   First Name   Last Name
Medical Information
Please list any medical conditions, medications, allergies, special needs, recent injuries, or behavioral accommodations/strategies we should know about to help your camper have the most successful and positive experience possible.*

Registration & Payment
If an opportunity becomes available for your camper to register for camp, you will be contacted by the Education Department to confirm registration and process payment information.
Should be Empty:

WAITLIST: Magik Theatre Goes To Broadway