Clone of Camp Confi(dance) 2026 K-5

Campers Full Name*

First NameLast Name

Campers Birthdate*

Date

Does your camper have any allergies or medical conditions we should be made aware of? Are there any special accomodations we should know about to make this experience successful?*

Is your child potty trained?*

Parent/Guardian Name #1*

First NameLast Name

E-mail*

example@example.com

Contact Number*

Format: (000) 000-0000.

Parent/Guardian Name #2

First NameLast Name

Contact Number

Format: (000) 000-0000.

Is there anyone else who may be picking up or dropping off your camper that we should know about?

Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

How did you hear about us???*

If you were referred by a friend please let us know who!

Medical Release and Participation Waiver: Parents, legal guardians of minors and adults waive the right to any legal action for any injury sustained on Level Up Performing Arts Center Property or event resulting from normal class/physical activity or any other activity conducted by the participant before, during or after class time. I have my own medical insurance to cover any and all medical bills or related bills that may arise from the nature of the activity. I release Level Up Performing Arts Center from all financial responsibility from any expense that is incurred for any unfortunate situation that may occur. I also consent to my child's photo being used in any images or marketing by Level Up Performing Arts Center. *

Select the white box in the top left corner of the box to add to your order!*