The Drama Club Fall 2024
Visit www.thedramaclubpa.com for full camp descriptions and payment policies. Deposit or full payment may be made on this form via PayPal or credit card.
Parent/Guardian Name
*
First Name
Last Name
Email - *PLEASE USE AN EMAIL ADDRESS THAT YOU CHECK REGULARLY, WE WILL USE THIS FOR ALL COMMUNICATION*
*
Confirmation Email
example@example.com
Email 2 - (Optional) Is there an additional email contact that you would like to add for another parent of guardian?
Confirmation Email
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Name
*
First Name
Last Name
Student Birthdate
*
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Month
-
Day
Year
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Emergency Contact 1
First Name
Last Name
Emergency Contact 1 Phone Number
-
Area Code
Phone Number
Emergency Contact 2
First Name
Last Name
Emergency Contact 2 Phone Number
-
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? THIS PROGRAM IS FULL, PLEASE FILL FORM FOR WAITLIST
*
Winnie The Pooh KIDS *WAITLIST*
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