KPAC Playhouse Theatre Non Instructional Day Camp Registration Form
All forms will be reviewed by the KPAC manager prior to enrollment. Filling out a registration form does not guarantee a space in care. Camp is for Ages: 12 to 18 years old. *mature 10-11 year old's may be accepted Day Camp's each NID 9 a.m. till 3:00 p.m.
KPAC NID Day Camp is $50 per day + a one time membership fee (if you are not a current member), per day.
Participants will have the opportunity to learn Theatre. Improv, performance, make up, costuming, working as a team, and more!
Select which Day camp you are registering your child for:
Friday, October 23, 2026
Monday, November 30, 2026
Monday, February 1, 2027
Monday, April 12, 2027
Friday, May 7, 2027
Friday, June 4, 2027
Participant Name
*
First Name
Last Name
Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred Pronouns
She/Her
He/him
They/Them
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Information
Name
*
First Name
Last Name
Relationship to participant
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Photo/Video Waiver - I the undersigned, authorize the KPAC and KCCC to use any photo/video of my child taken during class time to be used to market and promote the KPAC or KCCC in printed or other media publications, including but not limited to Facebook, City of Dawson Creek Leisure Guide, brochures and/or websites.
*
Yes
No
Does your child have any allergies, medical conditions, or support needs we need to be aware of?
*
Yes
No
If so, please describe
Required Consent
Please check boxes to confirm you have read, understand, and consent to the statements below.
Parent's Commitment - I have discussed with my child and confirm they agree to participate in the NID Theatre Day Camp Program and agree to follow safety instructions. I am aware that failure to follow safety rules or any inappropriate behaviour towards staff or students can result in removal of my child's participation in Camp.
*
Yes
No
Release of Liability - I release and discharge any and all rights and claims for damages of suit or action that my child may have at any time against the Kiwanis Arts Society Centre or the Kiwanis Child Care Centre, along with all employees and for any and all injuries suffered by my child as a result of participating in our NID Day Camp. KPAC/KCCC is not responsible for any lost or damaged personal items.
*
Yes
No
I, the undersigned, hereby certify that all the information provided is true and correct to the best of my knowledge and belief.
*
Submit
Should be Empty: