Acting Camp Registration Form

Acting Camp Registration

For Students Aged 8 to 16
STUDENT INFORMATION:
Child Name*

First NameLast Name
Child Name 2

First NameLast Name
Birth Date*

MonthDayYear
Age During Camp
Grade*
Which week(s) would you like to attend camp?*

Week 1, the week of June 8thWeek 2, the week of June 15thWeek 3, the week of June 22nd
T- Shirt Size

Youth SYouth MYouth LAdult SAdult MAdult LAdult XLAdult 2XL
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Would you like us to add you to our email list?

YesNo
How did you hear about us?
MEDICAL INFORMATION
Emergency Contact Name
Emergency Contact Number

Area CodePhone Number
Emergency Contact Number #2

Area CodePhone Number
Physician Name

First NameLast Name
Physician Phone Number

Area CodePhone Number
Medical Concerns
Allergies if Any
I/We, the undersigned, for ourselves, our heirs, executors, and administrators agree to hold Crayons Improv staff, agents, representatives, employees, successors, and assigns harmless from any injury my daughter/son may incur while involved with any camp activities and waive, release and forever discharge all named from any and all rights and claims for damages to person and property activities while participating in camp activities or resulting from camp activities. I/We understand that this is an independent camp and in no way is affiliated or sponsored by any other entity. My daughter/son is physically fit to take part in improv and camp-related activities. I/We hereby give Crayon Improv Camps & Clinics directors, coaches, training staff, and emergency personnel permission to render such medical and hospital care that in their judgment necessary for my daughter/son in the event of an injury, illness, or accident. I/We agree to bear the cost of any treatment such performed

__________________________________________________________________________________________
Signature

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My Products

Non-refundable Deposit $50.00

To hold your spot in camp, you can pay in full now or simply do a non-refundable $50 deposit. DO NOT PAY BOTH.

Improv Camp, FULL PRICE$175.00

The balance for camp is due before camp starts. If you paid a $50 deposit, you owe $125, do not pay the full price.

Improv Camp after deposit$125.00

If you paid $50 for camp deposit, you owe $125 for camp, due before the week of camp.

Total $0.00

Credit Card

Crayons Improv is happy to offer this performance based improv camp at Community Brookside

38th and Peoria above Pilates Studio

Crayons Improv Camp is every Monday through Friday the weeks that it is offered, (the week of Jun 8, the week of Jun 15th and the week of Jun 22).

Campers may attend all weeks, but content will be similar.

Crayons Improv Camp begins at 9 am on each day. Campers can be dropped off as early as 8:45 am

Camp ends at 3:00pm and campers can be picked up as late as 3:15

Friday we will perform for Parents at 7pm, call time for performers will be 6:30.

crayonsimprov@gmail.com.

Campers will participate in theatre improv activities as well as enjoy fun camp activities. This will be an active camp and students should dress to move.

Campers should bring a sack lunch and a snack every day.

Campers are encouraged to bring a refillable bottled water. Each week is only $175. Camp size will be limited, so register today.

Any questions are concerns about camp can be directed here: crayonsimprov@gmail.com 918-557-5616
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Acting Camp Registration

STUDENT INFORMATION:

PARENT/GUARDIAN INFORMATION:

MEDICAL INFORMATION

Credit Card