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.
* Required
Email address
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Your email
Student Last Name
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Your answer
Student First Name
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Your answer
Age & Birth Date
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Your answer
Address
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Your answer
Parent/Guardian #1 Name
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Your answer
Parent/Guardian #2 Name (If Applicable)
Your answer
Phone Number
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Your answer
Emergency Contact Name & Phone # (Must be different from Parent/Guardian)
*
Your answer
Camp Selection (Please check which camp session you would like to participate in for the 2021 Season)
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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
Required
T-Shirt Size
Child Small
Child Medium
Child Large
Child XL
Adult Small
Adult Medium
Adult Large
Adult XL
Clear selection
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.
I agree.
$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)
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Cash (bring to office or mail)
Check (bring to office or mail)
Credit Card
Required
I would like my final deposit to be...
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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
Other:
If paying by Credit Card (Call in card or leave information below)
Visa
Mastercard
American Express
Discover
I am a full year student. Please use my credit card on file.
Credit Card Number
Your answer
Expiration Date
Your answer
CVC
Your answer
How did you hear about our program?
I am a returning family
Friend or Family Member
Facebook Ad
Instagram Ad
Google Search
WNY Family Magazine
Kids Out & About
Other:
Any Allergies or anything else we should be aware of?
Your answer
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