PLACES! 2025 Registration
Please fill out the form for each student you are registering in the PLACES! Summer Camp
Ages: 8 - 15
Camp Hours: 9am - 4pm
Please select the week(s) you are registering your child for:
Week 1: July 7 - July 11 (Technical Theatre and Playwriting)
Week 2: July 14 - July 18 (Improvisation)
Week 3: July 21 - July 25 (Musical Theatre)
Week 4: July 28 - August 1 (Acting)
Student Information
Student Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Male
Female
Non-binary
Transgender
Intersex
Prefer not to answer
Pronouns
*
He/Him
She/Her
They/Them
Prefer not to answer
Ethnicity (please note this is strictly for reporting purposed and does not affect the scholarship selection process)
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Mixed/multiracial
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
*
Grade
*
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Custodial Parent / Guardian Information
Name
*
First Name
Last Name
Relationship to Student
*
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Please check one:
*
Custodial Parent/Guardian's address is same as student's
Custodial Parent/Guardian's address is different from student's
Custodial Parent / Guardian Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Relationship to Student
*
Please list any name permitted for pick-up/drop-off of student:
*
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Medical Information
Known Medical Problems / Special Concerns
*
Medications
*
Allergies
*
Physician's Name
First Name
Last Name
Physician's Office Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Physician's Office Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Hospital Preferred for Medical Treatment
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Parent Questionnaire
Please list student's previous participation in performing or visual arts:
*
What are some characteristics that would best describe your child?
*
What does your child enjoy doing the most?
*
What type of learner is your child?
*
Visual
Auditory
Reading & Writing
Kinesthetic
What do you hope your child will gain from the experience?
*
How did you hear about PLACES! Summer Camp?
*
What drew you to enroll your child in a theatre camp?
*
Is this your child's first camp experience?
*
Yes
No
Other
Is this your first time enrolling your child/children in an Arts Garage program?
*
Yes
No
Other
Is there anything you would like us to know in order to best serve your child?
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Terms of Agreement
I understand that if my camper is absent for more than three days in a row, they could their spot in the camp.
*
Yes
I understand that Arts Garage does not offer full refunds for camp registration.
*
Yes
BUY
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Submit
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