Chandler Summer Youth Musical

Chandler Summer Youth Musical

Spamalot: June 22-July 12
Participant's Full Name*

First NameLast Name
Participant's Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School*
Participant's Pronouns*
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
2nd Parent/Guardian Full Name*

First NameLast Name
2nd Parent/Guardian Email Address*
example@example.com
2nd Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
SLIDING SCALE TUITION

The true cost of camp is $450, but we ask families to select a tuition level that reflects their financial reality. Choosing a lower tuition level does not require documentation, justification, or explanation. Chosing a higher level will include tax deductbible donation, and a Chandler membership.

A flat registration fee of $50 will be due following registration to hold spot.
Supported $50/week $150 totalReduced $75/week $225 totalPartial $100/week $300 totalCore $150/week $450 total (true cost)Sustaining $200/week $600 totalPay-it-Forward $250/week $750 totalFull Scholarship
Check addressed to Chandler / 71 N Main Street, Randolph VT 05060 (most affordable option.)I will pay by card and I'm prepared to cover the transaction fees (3%)I will pay by money transfer * directions will be sent (1% fee)
YesNo
If no, are you interested in a speaking/singing role in Spamalot?
Have you acted on stage before? Tell us about it.
What is your experience with dance?
How will you arrive/leave camp? Pick up/ walk/ drive yourself?
YesNo
Are you interested in any other parts of the production? Tech? Costumes? Makeup?
Favorite snacks?
Does the participant have any allergies or any special needs we should know about?
T-Shirt Size?
I will competently assess my camper’s health and NOT send them to camp if they are showing any signs of illness, fever or other symptoms.*
If my child becomes ill while at camp I understand that I will be notified and will need to arrange for my child’s immediate pickup.*
If my child has a medical emergency while at camp I will be notified at my emergency contact number, and the secondary emergency contact will be notified but if neither can be reached, I give permission for immediate emergency medical treatment.*
I understand that if my child is unable to follow the rules and is endangering others, they may be sent home and no refund will be given.*
I understand that my child may be taken off the Chandler premises to participate in activities around the Randolph Village in Randolph, Vermont.*
I understand that Chandler, its Staff, its Volunteers, its Agents, and its Assigns may take photographs and video of my child for purposes of promotion or advertisement in print and social media for the benefit of Chandler. In addition, I understand that if I prefer that my child’s image or likeness not be used for these purposes, I will email Chandler staff within 48 hours of my child’s acceptance into Chandler’s camp and ask to have my child excluded from photographs and video prior to the start of my child’s camp experience.*
I/we agree to defend, indemnify, and hold harmless Chandler Center for the Arts, Inc., its Staff, its Volunteers, its Agents, and its Assigns from liability and claim for damages because of bodily injury, death, sickness, disease or less any expense arising from Chandler’s performance under this agreement .*
We understand that camp is a fun summer experience, but also serious and a lot of work to put on a full production, and attendance is very important. Attendance at all three weeks is required to participate in the play.*
Signature for Overall Agreement*

Clear
Should be Empty: