Registration

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Our Shining Stars camp ends with a fully staged production and 4 show run of Matilda Jr. Monday- Friday 9-2 pm July 10th- July 30th Shows July 28. 29, & 30 *Early Bird Special* Sign up before April 15th and pay $399 for camp!! $150 non refundable deposit required at time of sign up.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:

Questions/Options:


What Size T-shirt for your student. Please choose from Youth Small, Medium, Large or Extra Large or Adult Small, Medium, Large or Extra Large. *

Additional Information:

Agreement for Participation

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Release & Hold Harmless

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Photo & Video Release Form

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Payment Policy

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