TITP Summer Camp Registration Form

Week One - July 19 - 22, 2021

Week Two - July 26 - 29, 2021

9:00 a.m. - 4:00 p.m. Monday - Thursday

Thursday Night Performance each week

Actor's Information

Actor's Name Sibling #1 *

First Name Last Name

Actor's Preferred Nick Name

Nick Name

Birth Date *

Month Day Year

Age *

Grade

Entering Fall 2020

Gender

Male Female

T-shirt Size *

Does the actor have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the actor prescribed an inhaler? If yes, please explain any instructions.

Is there a friend your child would like to be grouped with for camp?

Is there anything you would like us to know about your actor?

Fill in below if signing up a second sibling.

If only one child, skip to parent information.

Actor's Name Sibling #2

First Name Last Name

Actor's Preferred Nick Name

Nick Name

Birth Date

Month Day Year

Age

Grade

Entering Fall 2020

T-shirt Size

Does the actor have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the actor prescribed an inhaler? If yes, please explain any instructions.

Is there a friend your child would like to be grouped with for camp?

Is there anything you would like us to know about your actor?

Parent/Guardian Information

Name *

First Name Last Name

Cell Number *

Area Code Phone Number

Home Number

Area Code Phone Number

E-mail *

Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Emergency Information

Emergency Contact's Name *

First Name Last Name

Relationship

Phone Number *

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Theater in the Park during the selected camp. In exchange for the acceptance of said child’s candidacy by Theater in the Park, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Theater in the Park. and all its respective directors, councelors, officers, agents, and representatives from any and all liability for injuries to said child arising out of participating in selected camp sessions.

In case of injury to said child, I hereby waive all claims against Theater in the Park, including all directors, counselors,coaches and affiliates, all participants, sponsoring agencies, advertisers, owners and lessors of premises used to conduct the event.

Photography and Video Consent

Pictures and video will be taken during the week of camp and shared on TITP website, social media as well as a link for parents to view. By signing below you consent to our use of images for this purpose.

Pricing and details:

Week One July 19 - 22 = $330.00

Week Two July 26 - 29 = $330.00

Sibling Discount = $640.00 for 2 - savings of $20. Price adjustment will show when 2 spots are selected. (If you have more than 2 kids, email us at www.theaterinthepark.spcc@gmail.com for price adjustments)

NOTE: All fees for this camp are non-refundable. If a student is unable to attend the camp and notice is given two weeks prior to start date, 75% of the workshop fee can be used toward future Theater in the Park workshops. After that date, the tuition fee for the assigned workshop will be forfeited as the tuition fees are used to fund the staff, matarials and space as projected for the workshop.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Sign here *

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My Products *

TITP Summer Camp Week One $ 330.00

July 19 - 22 9:00am - 4:00pm with Thursday night performance

Quantity
Item subtotal: $ 0.00

TITP Summer Camp Week Two $ 330.00

July 26 - 29 9:00am - 4:00pm with Thursday night performance

Quantity
Item subtotal: $ 0.00

TITP Summer Camp BOTH WEEKS $ 640.00

Both weeks, July 19 - 22 and July 26 - 29. 9:00am - 4:00pm. Thursday night performances. Both weeks are same program but can be placed with a different director each week.

Quantity

Total $ 0.00

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Theater in the Park Summer Camp