REGISTRATION FORM

(One child per form) Camper Info

Campers Full Name: ______________________________________________________ Campers Preferred or Nickname: ____________________________________________ Campers Age: ________ T-Shirt Size: _______________ Gender: ________________

Parent/Guardian Info:
Fathers Name: ___________________________________________________________ Father's Home Phone: (___) ______________ Home Address: ________________________ City: __________________ State: _________________ ZIP: __________________ Fathers Place of Business: _________________________________________________ Work Phone: (___) _____________ Cell Phone: (___) _____________ Fathers E-Mail: _____________________________________________________ Mother's Name: ______________________________________________________ Mother's Home Phone: (___) ______________ Home Address: _____________________ City: _____________________ State: _____________________ ZIP: ____________________ Mothers Place of Business: ________________________________________________ Work Phone: (___) _____________ Cell Phone: (___) _____________ Mothers E-Mail: _______________________________________________

CHECK SESSIONS ATTENDING Session #1 June 25th July 12th 6-13 yr .olds Mon-Thurs 8:30 am 4 pm $198.00 per week Total Session 1 $594.00 Session #2 July 16th Aug. 2nd 6-13 yr. olds Mon-Thurs 8:30 am 4 pm $198.00 per week Total Session 2 $594.00 Session #3 Aug 6th Aug.16th 3-5 yr. olds Mon-Thurs 8:30 am 12 pm $128.00 per week Total Session 3 $256.00 TOTAL TUITION______________________________ $30.00 Registration Fee due with registration I am paying by (select one): Check #________________ or Cash _________ TOTAL AMOUNT ENCLOSED $_____________

REGISTRATION & POLICIES How to Register

Procedure & Waiver and Release Form at Over the Rainbow 146 Rt. 130 South, or download forms from the summer camp page on our website - www.openartsstage.com Complete the Registration Form & the Emergency Procedure & Waiver and Release Form Make check payable to Open Arts Stage for first week plus a $30.00 non-refundable registration fee. Bring forms and payment in-person to Over the Rainbow office - weekdays 9AM-5PM, 146 Rt. 130 South or mail them to the same location. Advance registration is required. Thirty dollar non-refundable registration fee is due at the time of registration. Programs are subject to minimum and maximum enrollment and are filled first-come, first-served. Acceptance is automatic unless notified. Students are responsible for arriving on the correct day and time. Receive a 10% discount when registering more than one sibling from the same family.

Pick-up Registration Form & the Emergency

CANCELLATIONS & REFUNDS

Open Arts Stage Performing Arts Summer Camp reserves the right to cancel any camp class at any time and refund tuition. Written notice up to 1 week prior to the classs start is required to drop a class and obtain a refund. A $10 processing fee will be assessed. No credits or refunds will be given within 1 week prior to a sessions start. Student-missed classes cannot be re-scheduled, nor will refunds/credits be issued.

RULES OF CONDUCT INCLUDE:

No smoking in the building. No defacing property. No interference with employee duties. No disruptive, inappropriate, or indecent conduct or language. No unauthorized use of illegal drugs, intoxicants and/or weapons.

Open Arts Stage Performing Arts Summer Camp strictly prohibits any conduct that is disruptive or may jeopardize the safety of others.

OPEN ARTS STAGE PERFORMING ARTS SUMMER CAMP RESERVES THE RIGHT TO: Substitute faculty as needed. Adjust program details printed in marketing materials. Photograph program participants for publicity use. Remove any student if he/she is disruptive or interferes with the safety or participation of others and to suspend a child from a program, without refund, after notifying parent of disciplinary problems. Deny registration or entry when deemed necessary for public safety.

MEDICAL INFORMATION Parents are responsible for consulting with a physician regarding their childs physical condition and ability to participate in camp. All program participants must complete Open Arts Stage Performing Arts Summer Camp Emergency Form/Waiver & Release and health form. For emergencies requiring immediate medical attention, staff will call 911 and notify the students parent or emergency contact. Open Arts Stage Performing Arts Summer Camp is not peanut-free; however, upon receipt of notification of any food allergies reasonable safety measures are taken.

Parent/Guardian Signature: ____________________________________ Date: ____/____/____