Galloway Theater Camp
Event Timing: July 10-21, 2017, 8:30am-12pm
Event Address: 305 North Congress Street, Jackson, MS 39201
Contact us at (601) 353-9691 or
Child's Name *
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Parent/Guardian Name *
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Parent/Guardian Email *
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Parent/Guardian Phone Number *
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Child's Age *
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Grade Completed in May 2017(1-12) *
Does your child have previous experience in acting, singing, and/or dancing? If so, please share briefly about this experience.
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Does your child have any allergies or relevant medical conditions for camp participation? *
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Other Requirements
All students must submit completed 2017 medical release form (available at to Galloway UMC by Friday, June 16. Medical release forms may be submitted by email to, in person or by mail to Galloway's office at:

Attn: Rev. Elizabeth Henry
305 N Congress Street
Jackson, MS 39201

I understand that payment of $100 per child is due to Galloway UMC by Friday, June 16 to complete registration. *
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