Registration

Registration at this time is FULL

* Indicates required field

Family Name (Last Name) *

Primary Parent/Guardian Name *

First

Last

Primary Parent/Guardian Phone Number *

Primary Parent/Guardian Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Secondary Parent/Guardian Name *

First

Last

Secondary Parent/Guardian Phone Number *

Secondary Parent/Guardian Email *

Child #1

Child #1 Name *

First

Last

Child #1 Age *

Child #1 Birthday *

Child #1 Grade in 23/24 School Year *

Child #1 Medical Conditions/ Concerns *

Child #1 Allergies *

Child #1 Emergency Medications *

Would you permit you child be given Acetaminophen (Tylenol) if deemed necessary by a champ director? *

Yes No

In the event that it is needed can your child apply sunscreen provided by Stage Door Camp Director or Counselors? *

Yes No

In case of a serious illness or injury when neither parent or guardian can be reached, will you allow your child to be transported to a doctor or hospital by adult Stage Door personal? *

Yes No

At times during the course of rehearsal your child/children my appear in a photo or video. If you wish for those photos or videos to not be used on our site or in our program please specify below. *

Yes, photos may be used by Stage Door No. photos may not be used by Stage Door.

Child #2

Child #2 Name *

First

Last

Child #2 Age *

Child #2 Birthday *

Child #2 Grade in 23/24 school year *

Child #2 Medical Conditions/Concerns *

Child #2 Allergies *

Child #2 Emergency Medications *

Would you permit you child be given Acetaminophen (Tylenol) if deemed necessary by a champ director? *

Yes No

In the event that it is needed can your child apply sunscreen provided by Stage Door Camp Director or Counselors? *

Yes No

In case of a serious illness or injury when neither parent or guardian can be reached, will you allow your child to be transported to a doctor or hospital by adult Stage Door personal? *

Yes No

At times during the course of rehearsal your child/children my appear in a photo or video. If you wish for those photos or videos to not be used on our site or in our program please specify below. *

Yes, photos may be used by stage door. No, photos may not be used by stage door.

Child #3

Child #3 Name *

First

Last

Child #3 Age *

Child #3 Birthday *

Child #3 Grade in 23/24 School Year *

Child #3 Medical conditions/concerns *

Child #3 Allergies *

Child #3 Emergency medications *

Would you permit you child be given Acetaminophen (Tylenol) if deemed necessary by a champ director? *

Yes No

In the event that it is needed can your child apply sunscreen provided by Stage Door Camp Director or Counselors? *

Yes No

In case of a serious illness or injury when neither parent or guardian can be reached, will you allow your child to be transported to a doctor or hospital by adult Stage Door personal? *

Yes No

At times during the course of rehearsal your child/children my appear in a photo or video. If you wish for those photos or videos to not be used on our site or in our program please specify below. *

Yes, photos may be used by stage door. No, photos may not be used by stage door.

Emergency Contacts and phone # *

Individuals My Child/Children may be released to *

If there are any activities that your child/children may not participate in please list them below. *

Please send a $100 non-refundable deposit per child made out to Stage Door, if you can not send a check please contact director Amy Moritz to make other payment arrangements. Deposit will be applied to camp tuition, total of $550.

Registration Is Closed

Registration

Registration for our 2025 summer will open on March 1st, 2025

Deposit Information

Registration at this time is FULL

Child #1

Child #2

Child #3

Please send a $100 non-refundable deposit per child made out to Stage Door, if you can not send a check please contact director Amy Moritz to make other payment arrangements. Deposit will be applied to camp tuition, total of $550.