Mosaic Youth Theatre of Detroit Online Registration

Registration

Already a customer? Click here to login.

Welcome to Mosaic's 2023 Summer Camp Registration Page!

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Health Insurance Carrier*

# of people in your household?*

Annual Household Income*

Do you receive food benefits?*

Do you receive cash benefits?*

Consider for scholarship? Y/N*

Contact #1

Parent/Guardian 1 First Name*

Last Name *

Relationship to Student*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Relationship to Student

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Waldorf Camp runs July 10th-21st, 9am-3pm

Brightmoor Camp runs July 24th-August 4th, Full-day 9am-3pm Half day 12pm-3pm

Please click on the Search button below, then choose the camp that you wish to register your student for:

-Mosaic Summer Camp Waldorf Grades 3/4

-Mosaic Summer Camp Waldorf Grades 5/6

-Mosaic Summer Camp Waldorf Grades 7/8

-Mosaic Summer Full Day Camp Brightmoor Grades 3/4

-Mosaic Summer Full Day Camp Brightmoor Grades 5/6

-Mosaic Summer Full Day Camp Brightmoor Grades 7/8

Half Day camps are intended for Detroit Community Schools Summer School Students

-Mosaic Summer Half Day Camp Brightmoor Grades 3/4

-Mosaic Summer Half Day Camp Brightmoor Grades 5/6

-Mosaic Summer Half Day Camp Brightmoor Grades 7/8

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Waldorf Camp runs July 10th-21st, 9am-3pm

Brightmoor Camp runs July 24th-August 4th, Full-day 9am-3pm Half day 12pm-3pm

Please click on the Search button below, then choose the camp that you wish to register your student for:

-Mosaic Summer Camp Waldorf Grades 3/4

-Mosaic Summer Camp Waldorf Grades 5/6

-Mosaic Summer Camp Waldorf Grades 7/8

-Mosaic Summer Full Day Camp Brightmoor Grades 3/4

-Mosaic Summer Full Day Camp Brightmoor Grades 5/6

-Mosaic Summer Full Day Camp Brightmoor Grades 7/8

Half Day camps are intended for Detroit Community Schools Summer School Students

-Mosaic Summer Half Day Camp Brightmoor Grades 3/4

-Mosaic Summer Half Day Camp Brightmoor Grades 5/6

-Mosaic Summer Half Day Camp Brightmoor Grades 7/8

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Waldorf Camp runs July 10th-21st, 9am-3pm

Brightmoor Camp runs July 24th-August 4th, Full-day 9am-3pm Half day 12pm-3pm

Please click on the Search button below, then choose the camp that you wish to register your student for:

-Mosaic Summer Camp Waldorf Grades 3/4

-Mosaic Summer Camp Waldorf Grades 5/6

-Mosaic Summer Camp Waldorf Grades 7/8

-Mosaic Summer Full Day Camp Brightmoor Grades 3/4

-Mosaic Summer Full Day Camp Brightmoor Grades 5/6

-Mosaic Summer Full Day Camp Brightmoor Grades 7/8

Half Day camps are intended for Detroit Community Schools Summer School Students

-Mosaic Summer Half Day Camp Brightmoor Grades 3/4

-Mosaic Summer Half Day Camp Brightmoor Grades 5/6

-Mosaic Summer Half Day Camp Brightmoor Grades 7/8

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Waldorf Camp runs July 10th-21st, 9am-3pm

Brightmoor Camp runs July 24th-August 4th, Full-day 9am-3pm Half day 12pm-3pm

Please click on the Search button below, then choose the camp that you wish to register your student for:

-Mosaic Summer Camp Waldorf Grades 3/4

-Mosaic Summer Camp Waldorf Grades 5/6

-Mosaic Summer Camp Waldorf Grades 7/8

-Mosaic Summer Full Day Camp Brightmoor Grades 3/4

-Mosaic Summer Full Day Camp Brightmoor Grades 5/6

-Mosaic Summer Full Day Camp Brightmoor Grades 7/8

Half Day camps are intended for Detroit Community Schools Summer School Students

-Mosaic Summer Half Day Camp Brightmoor Grades 3/4

-Mosaic Summer Half Day Camp Brightmoor Grades 5/6

-Mosaic Summer Half Day Camp Brightmoor Grades 7/8

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Waldorf Camp runs July 10th-21st, 9am-3pm

Brightmoor Camp runs July 24th-August 4th, Full-day 9am-3pm Half day 12pm-3pm

Please click on the Search button below, then choose the camp that you wish to register your student for:

-Mosaic Summer Camp Waldorf Grades 3/4

-Mosaic Summer Camp Waldorf Grades 5/6

-Mosaic Summer Camp Waldorf Grades 7/8

-Mosaic Summer Full Day Camp Brightmoor Grades 3/4

-Mosaic Summer Full Day Camp Brightmoor Grades 5/6

-Mosaic Summer Full Day Camp Brightmoor Grades 7/8

Half Day camps are intended for Detroit Community Schools Summer School Students

-Mosaic Summer Half Day Camp Brightmoor Grades 3/4

-Mosaic Summer Half Day Camp Brightmoor Grades 5/6

-Mosaic Summer Half Day Camp Brightmoor Grades 7/8

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)