Cultural Arts Theater Summer Camp Registration
Camp Dates: June 24 – July 17, 2025 Days: Tuesdays, Wednesdays, & Thursdays | Time: 11:00 AM – 4:00 PM | Cost: $500 per child | $100 off per additional sibling | Military Discount: $400 for the first child | $375 for each additional sibling
1. CAMPER INFORMATION:
Child Name
*
First Name
Last Name
Birth Date
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Month
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Day
Year
Date
Child Name
First Name
Last Name
Birth Date
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Month
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Day
Year
Date
Child Name
First Name
Last Name
Birth Date
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Month
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Day
Year
Date
2. PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
3. MEDICAL INFORMATION
Medical Concerns/Allergies
4. Authorized Pick-Up List (Name and Phone Number)
*
Tell us a little about your camper
5. Waivers & Agreements
*
I acknowledge that participation in this camp involves physical activity and release Cultural Arts Theater Inc. from liability.
I authorize staff to seek emergency medical treatment for my child if needed.
I give permission for my child to be photographed or recorded for promotional purposes.
I understand that disruptive behavior may result in removal from the program without refund.
Parent/Guardian Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit this completed form and payment to secure your child’s spot!
For questions, email: info@culturalartstheater.org or call 813-395-3402 Website: https://culturalartstheater.org Instagram: @cultural.arts.theater
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