Fields marked with an asterisk (*) are required.
Parent's Name *
Student's Name *
Student's Grade - Fall 2019 *
Street Address *
City:*
State: * Zip: *
Parent's Email *
Home Phone
Cell Phone
Emergency Contact's Name *
Emergency Contact's Phone *
Does this camper have any allergies? If so, please describe:
What over-the-counter medications can be administered to camper during camp? Check all that apply: TylenolIbuprofenBenadrylTums
Check below if you give Facetime Theatre permission to call for emergency services for your child should a medical emergency arise. Yes I give Facetime permission to call for emergency servies.
My first choice of camps is (check one): *
Magic Tree House Kids (June 17 - June 29)Jungle Book Kids (August 5 - August 17)
If my first choice of camps is full, I (check one): *
Would like to participate in the other campAm unable to/not willing to participate in the other camp
Check below if you would like to participate in both camps. Yes, I would like to participate in both camps.
Check below if you would like to enroll in extended day. Yes, I would like to enroll in extended day.
Check below if you give Facetime Theatre permission to take photographs and/or video of your child which may be used in future online and print promotional materials. Yes, I give Facetime permission to take photo and/or video of my child to use in future online and print promotional materials.
Additional Comments or Questions:
(Upon submission you should be redirected to the Summer Stage Registration Page to make your payment. If you are not, please return to the registration page to send in your payment. Your registration is not complete until we receive your form and your payment. Thank you.)