Child Information

Camper Name

First Name

Last Name

Birthdate

YYYY

Age

Please check if you are attending this camp

Wizardry Summer Camp Session 1 June 10th- June 14th

Please check if you are attending this camp

Wizardry Summer Camp Session 2 July 8th- July 12th

Please check if you are attending this camp

Trolls Band Together Musical Theatre Camp July 29th- Aug 2nd

Please check if you are attending this camp

Technical Theatre Camp July 29th- Aug 2nd

If you are a 2nd year Wizardry camp attendee, let us know what sort of new things you may want to have the opportunity to do as a second year. There are no guarantees but we would love to hear your ideas.

If you are a 2nd year Wizardry Camper please check here to agree to this: I solemnly swear to not reveal any Hogwarts secrets or surprises to any first years.

Check the box to agree

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Parent/Gaurdian - Contact Information

Parent/Gaurdian #1

First Name

Last Name

Parent/Guardian 1 Address is the same as camper

Yes

No- if no please fill out address info below

If parent/guardian 1's address is different, please list here:

Cell Phone

(###)

###

####

Parent/Gaurdian #2 *

First Name

Last Name

Parent/Guardian 2 Address is the same as camper

Yes

No- if no please fill out address info below

If parent/guardian 2's address is different, please list here:

Cell Phone *

(###)

###

####

Fax

Email *

Emergency Contact Information - Alternate Pickup/Release

Emergency Contact #1 *

First Name

Last Name

Cell Phone *

(###)

###

####

Email *

Relationship to Child *

Emergency Contact #2

First Name

Last Name

Cell Phone

(###)

###

####

Relationship to Child

Please list those people in addition to parents/guardians who are permitted to pick up your child:

Person 1:

Person 2:

Person 3:

Medical Release Information

Insurance information

Policy Number *

Name of Health Insurance Provider *

Primary Physician *

Physician Office Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Physician Office Phone *

(###)

###

####

Hospital Preference *

Please list any medical problems, including any requiring maintenance medication

Medical Problem

Required Treatment

Should paramedic be called?

Yes

Medical Problem

Required Treatment

Should paramedic be called?

Yes

Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

Yes

If yes, please explain:

Is your child allergic to any type of food or medication?

Yes

If yes, please explain:

In case of medical emergency contact:

Contact #1 *

First Name

Last Name

Phone *

(###)

###

####

Relationship to Child *

Contact #2

First Name

Last Name

Phone

(###)

###

####

Relationship to Child

I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill.

Parent/Guardian Initials *

Please tell us how you learned about Wagner Summer Theatre

If other, please specify

Cancellation Policy

Wagner Summer Theater has the right to cancel a class/ camp/ or production up to one week prior to the start date. Refunds will be processed if a class is canceled. Wagner Summer Theatre has the right to determine minimum enrollment. A refund will not be given if purchaser believes the enrollment is low. Class enrollment is only valid toward the season enrolled and cannot be applied to a class or camp in a later season. At Wagner Summer Theater, we pride ourselves on offering high quality classes and programs. We base our staffing and program budgets on the number of students enrolled in each program. Tuition for Wagner Summer Theater programs is non-refundable. If a participant notifies Wagner Summer Theater in writing 30 days prior to the start of a program, it is possible to transfer the tuition to another available program in the same or upcoming season. A change fee of $20 will be applied for such changes.

Nut Policy

Wagner Summer Theatre’s classes/ camps and productions are NUT-FREE environments. This includes, but is not limited to, peanuts and tree nuts, including almonds and cashews. There is a strict no-sharing policy.

Drop-off/Pick-up Policy

Drop-off begins 10 minutes prior to the start of camp or class. Children must be picked up no later than 10 minutes after camp or class ends.

Student Cell Phone Policy

Cell phones, smart watches, and any other communication devices may not be used while rehearsals are in session, including break and lunch time. Students who bring cell phones must keep them in their backpacks and TURNED OFF while at class/camp. We want to promote bonding of the cast through conversation. Videotaping/recording will be permitted on a case by case basis at the discretion of the teacher for the students’ own at-home rehearsal. Failure to follow these guidelines may result in confiscation of the phone until end of class/camp/rehearsal. If you need to communicate with your child, please call or text me at 773-263-2007 the office and we will relay information to the class/camp.

Policies: Parent/Guardian Initials

Terms of Agreement

Photo Release

I hereby give permission for my child to be photographed during the Wagner Summer Theater. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet. I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Wagner Summer Theatre and its affiliates.

Photo Release: Parent/Guardian Initials

Wagner Summer Theater and its co-organizers are not responsible for lost or damaged personal property. All scheduled events are subject to change. I understand that no fees will be refunded or transferred unless a child is unable to participate due to an accident or illness per physician orders. Children's’ photos and quotes may be used for publicity purposes. In case of an emergency, and if a family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (i.e. EMT, First Responder, and/or Physician).

E-signature

Date

YYYY

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Thank you for registering for camp with Wagner Summer Theater!

If you need to fill out this information for an addition child please click here:

2024 SUMMER CAMP CLASS Registration