Drama Kid's Camp - 4/27/19
Please complete this Parental Consent Form to register your child for camp. Please make check out to "Kellam High School" and mail to Kellam Drama, 2665 West Neck Road, Virginia Beach, VA 23456.
Child's last name *
Your answer
Child's first name *
Your answer
Male or Female *
Age *
Your answer
Grade *
Parent/Guardian Last name *
Your answer
Parent/Guardian First name *
Your answer
Parent/Guardian e-mail: *
Your answer
Parent/Guardian cell phone number *
Your answer
Emergency Contact name *
Your answer
Emergency Contact phone number *
Your answer
My child may wear stage make-up and/or have his/her face painted. *
If the age group needs to be split because of numbers, list any "friends" with whom your child would like to be kept in a group. Children need to be within a year or two to keep in same group.
Your answer
Camper's Health Information - Please check all that apply. *
Required
If applicable, explain "other" Health issues.
Your answer
List any allergies to Drugs
Your answer
List any food allergies
Your answer
List any current medications
Your answer
Is tetanus immunization up to date? *
List any physical restrictions.
Your answer
List all persons who may pick up your child.
Your answer
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