2020 Summer @ Live Arts Camp Registration and Permissions Form for Treasure Trunk Mini Camp (Ages 4-6) and Fractured Fairy Tales Camp (Ages 6-9)
Your registration for 2020 Summer @ Live Arts Treasure Trunk Mini Camp(s) and/or Fractured Fairy Tales Camp(s) is complete once you submit payment for the camp(s) AND fill out this form. Please complete this form for each child you are registering. If you are registering the same child for multiple camps, you need only fill this form out once.

Liability Release Form *
*My child has my permission to participate in Live Arts Summer Camp. I understand that I am responsible for any damage to property or persons resulting from my child's actions. I understand that consumption or possession of alcohol or illegal drugs is not permitted. I give permission for Live Arts staff to call for emergency medical services in the event that I or the emergency contact person cannot be reached and before contacting me if the Live Arts personnel deem it appropriate. I hereby release and agree to indemnify and hold harmless Live Arts, its agents, employees, officers, and directors from any and all responsibilities and liability for injuries to my child while enrolled in a Live Arts Camp.
Name of child *
Age *
School *
My child will enter the following grade in the fall *
Please indicate which Summer Camp(s) you are registering for below. *
Check all that apply!
Name of Parent/Guardian *
Relationship to child *
Cell # *
Home #
Work #
Email *
Name of Second Parent/Guardian (if applicable)
Second Parent/Guardian Relationship to Child (if applicable)
Second Parent/Guardian Cell # (if applicable)
Second Parent/Guardian Email (if applicable)
Please list any other person who is authorized to pick up your child, if applicable:
Emergency Authorization and Consent for Summer Camp *
I/We undersigned parents or legal guardians of the minor registered do hereby give authorization and consent for medical treatment in the event my child becomes ill or injured during a Live Arts summer camp. Live Arts Staff or volunteers are authorized to take one or more of the following actions: a) provide reasonable basic first aid; b) release my child to the person listed below; c) take my child to a physician or call the physician indicated; or, d) take my child to the hospital and/or give consent for emergency care.
Person in addition to parent or guardian to contact in emergency (and relationship to minor) *
Cell # *
Home #
Work #
Doctor's Name *
Doctor's Office Address *
Doctor's Phone # *
Please indicate any significant health history of which Live Arts should be aware.
Please list all allergies, dietary restrictions, and/or medications. *
Does your child have any special needs, (behavioral, medical, emotional, etc.), we should be aware of to help your child have a safe and positive camp experience?
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IF YOU CHECKED *YES* ABOVE: A Live Arts summer staff member will call prior to your camper's arrival to discuss how we can best help your camper to have a positive experience. Please indicate below that you understand and agree to be contacted. [IF YOU CHECKED NO PLEASE SKIP TO THE NEXT QUESTION.]
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