2017 Musical Theater Summer Camp Registration

Each camper must bring a packed lunch and water bottle every day.

 

Child'#1 Name *
Child'#1 Name
Child #2 Name
Child #2 Name
Child #3 Name
Child #3 Name
Parent/Guardian Name
Parent/Guardian Name
Address
Address
Best Phone #1
Best Phone #1
Best Phone #2
Best Phone #2
Emergency Contact
Emergency Contact
in the event of emergency and parent/guardian cannot be reached
Emergency Phone
Emergency Phone
If your child(ren) would like to be on the same team with a friend or sibling. Please enter the name of the friend/sibling below.
Medical Release *
I understand that every precaution will be taken for the safety and well-being of my child(ren). In the event of an accident or sickness, however The Community Chapel, its staff and volunteers are hereby released from any and all liability with the above activity by The Community Chapel, its staff, volunteers, or agents. In case of medical emergency, I understand that hospital policy requires parent/guardian permission before treatment. I hereby give permission to a representative of The Community Chapel to secure proper medical treatment if a parent or guardian cannot be reached.
Photo/Video Release *
I agree to and realize that my child(ren)'s photograph or video may be taken during the event. I waive the right to inspect or approve the image if used for publications or publicity in social media or print.