ECTC Registration "Camp Broadway" at Seaside Neighborhood School
One week Monday through Friday Camp  
In partnership with the Mattie Kelly Arts Foundation

Let the Broadway rhythm get you! Come act, sing and dance your heart out to popular Broadway tunes as we learn songs and simple choreography to some of the musical numbers from Broadway. We'll play improvisation and theatre games too. Watch out parents, we'll WOW you with a performance the last day of camp!  Monday through Friday 9am to 12:30pm Grades 3 through 10, $125 tuition

July 6-10, Seaside Neighborhood School


www.emeraldcoasttheatre.org
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Parent / Guardian Information
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Student's Information
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Thank you for registering with Emerald Coast Theatre Company!
Payment/Registration Information: To register, please complete this form and either pay by credit card through PayPal or mail your check to Emerald Coast Theatre Company, PO Box 9175, Miramar Beach, FL 32550.  (Please include a note with your name, your phone number, the student's name, and the class title/date/location enclosed.) Upon receipt of your payment we will then process your registration form at which time your space in the selected class/camp will be reserved. No refunds are given except in the case of a military transfer.  Class schedules may be subject to change due to long wait lists or low enrollment. In the event of low enrollment and classes being cancelled, full refunds will be given.  As a registrant you will be added to our electronic newsletter, we do not share or sell your information.  Please initial in the box if you have read and agree. *
Release of Liability: As the legal parent or guardian, I release and hold harmless Emerald Coast Theatre Company, its officers and directors, and employees from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Emerald Coast Theatre Company, its officers, directors and employees in route to or from any of said premises.   Please initial in the box if you have read and agree. *
Physical Activity:  I understand that as a participant, my child may be climbing on and off of stage and set pieces, including stairs. I further understand that my child may be  running, jumping, dancing and varied other movements on stage.  I understand that my child may be running, jumping, dancing near movable  set pieces. I assume all risks and hazards to such participation including  transportation to and from rehearsals and performances and hereby waive,  release, absolve and indemnify and agree to hold harmless, Emerald Coast Theatre Company and host facility and its officers, directors, employees,  and participants for any claim arising out of accidental injury to my child.  Please initial in the box if you have read and agree. *
Medical Consent: The undersigned gives permission to Emerald Coast Theatre Company, its officers, directors, volunteers, and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I further acknowledge that I will be responsible for any  medical or hospital fees or costs associated with my child’s medical  treatment. I hereby declare any physical/mental problems, restrictions, or conditions and/or/declare the participant to be in good physical and mental health.  Please initial in the box if you have read and agree. *
Student Images: Emerald Coast Theatre Company reserves the right to photograph and videotape programs and participants for training, advertising, or any other lawful business purpose. Emerald Coast Theatre Company may publish recognizable images of your child in any medium deemed appropriate by Emerald Coast Theatre Company, including, but not limited to web pages, social media, newspapers, TV broadcasts, multimedia presentations and pictures for professional journals and magazines. Please initial in the box if you have read and agree. *
Student Pick Up: If your child will be picked up, please make sure authorized pick up person arrives promptly at class end time and waits outside of the room. 1st late pick up less than 10 minutes will result in a warning. EACH 10 minutes thereafter, will result in a fee assessment of $15 charged. 2nd late pick up will result in an automatic fee assessment of $15 for EACH 10 minute increment and will be charged.  Please initial in the box if you have read and agree. *
Expectations: Any student unable to maintain appropriate behavior throughout the duration of the program, may result in not being allowed to attend remaining classes. Parents will be notified with a written/verbal warning prior to any removal. Refunds will NOT be issued for any student removed for this reason.  Please initial in the box if you have read and agree. *
Please enter your full name as your electronic signature of this form. *
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CAR POOL: I want my name, phone number, and email address released to other ECTC parents so we can arrange a car pool from:
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