Summer Camp 2019
Complete a separate form for each camper. Note, a spot will not be reserved until camp deposit is paid. Pay online at https://www.nextstarpac.com/camp.html
Email address *
Camp day option *
Required
Name of child *
Your answer
Age *
Grade just completed *
School
Your answer
Describe any Medical conditions( list any allergies, etc.)
Your answer
Describe any other conditions( emotional, etc.)
Your answer
Parent Name *
Your answer
Phone number *
Your answer
Emergency contact name *
Your answer
Emergency contact phone number *
Your answer
Consent
By clicking SUBMIT I agree and give my consent to the following:
The next star arts program (Next Star) staff takes all necessary precautions to ensure the safety of the students in their care. I agree to hold harmless Next Star or its partners, their agents, officers and/or employees from all claims, damages, injuries, or other liabilities of any kind whatsoever that could be brought now or in the future by me arising from any action or inaction.

I understand that certain reasonable risks may exist in allowing my child to participate in the program.
I agree to be responsible for all medical bills, costs, and expenses (including ambulance services) incurred in providing necessary care to my child, and/or I authorize the direct billing of my health insurance carrier. In cases of emergency, Next Star shall act merely as my agent and neither Next Star nor its staff shall incur any liability for the good faith exercise.

I understand that all tuition payments are non-refundable.

I understand that my child may appear in photographs and videos taken in the normal course of a class and during productions. I hereby authorize Next Star and to use such images and video for promotional purposes only.

A copy of your responses will be emailed to the address you provided.
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