Academy of Theatre Arts 2021 Summer Registration Form
*Please make sure email address is up to date and checked frequently. We use a completely electronic system.
Student Last Name
Student First Name
Age & Birth Date
Parent/Guardian #1 Name
Parent/Guardian #2 Name (If Applicable)
Emergency Contact Name & Phone # (Must be different from Parent/Guardian)
Camp Selection (Please check which camp session you would like to participate in for the 2021 Season)
Session A: BROADWAY AT ATA July 5th - July 16th 9:00-4:00pm (Ages 12 & up) $450
Session B: ONSTAGE AT ATA July 19th - July 30th 9:00-4:00pm (Ages 9-11) $450
Session B-1: ONSTAGE AT ATA (AGES 12 & up SECTION) July 19th - July 30th 12:00-4:00pm $200
Session C: CATCH A RISING STAR August 2nd-6th 9:00-3:00pm (Ages 5-9) $225
Session D: CATCH A RISING STAR August 9th-13th 9:00-3:00pm (Ages 5-9) $225
Session E: CATCH A RISING STAR August 16th-20th 9:00-3:00pm (Ages 5-9) $225
Session F: BROADWAY BABIES August 9th-13th 9:00-12:00pm (Ages 3-4*) $150
PARENTAL CONSENT:I agree by checking to follow all policies and procedures set forth by Academy of Theatre Arts. I accept the responsibility of reading and following all information communicated by the Academy. I further accept all responsibility of any potential risk associated with participating in a theatre class, and affirm that I have and will provide proper health insurance for my child’s protection. I give permission for emergency medical treatment of my child if a parent cannot be contacted. I hereby grant permission for my child to be photographed by Academy of Theatre Arts for publicity and/or production purposes.
$50.00 Non-Refundable Deposit: (This deposit goes to items that are purchased before the start of camp and cannot be refunded for any reason)
Cash (bring to office or mail)
Check (bring to office or mail)
I would like my final deposit to be...
Billed via Credit Card for the final amount on June 1st
Will bring cash or check for final amount by June 1st
Send invoice for final amount
I am paying in full with my deposit
If paying by Credit Card (Call in card or leave information below)
I am a full year student. Please use my credit card on file.
Credit Card Number
How did you hear about our program?
I am a returning family
Friend or Family Member
WNY Family Magazine
Kids Out & About
Any Allergies or anything else we should be aware of?
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