2021 Summer Camp Registration
This registration does not guarantee you a place at camp until payment is made. We will send you an email with instructions. Please insert your name accepting this.
Email *
Camp Week: *
Required
Name *
Email *
Phone Number *
Home Address *
City *
State *
Zip *
Child's Name *
Child's Date of Birth *
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Child is
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TShirt Size
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Insurance Information: Company/Policy Holder Name and Group Number *
Allergies: *
Medications or Conditions we need to know:
In Case of Emergency, Contact Name/Relationship: *
In Case of Emergency, Contact Phone Number: *
Certification Statement:
I certify I am the parent or guardian of the above-named minor child. I consent to participation in the activities associated with the Carteret Community Theatre Summer Camps. I understand I assume the risks of participation by my minor child, including but not limited to the risk of injury and property loss/damage. I waive liability and hold harmless Carteret Community Theatre and its agents, staff, and volunteers. The staff and volunteers of Carteret Community Theatre Summer Camps shall not be responsible for any consequences from any diagnostic or medical treatment and are released from any and all claims and causes of action that may arise.
I acknowledge the above statement and understanding of this waiver of liability. I consent to my child receiving medical treatment as needed in the case of an emergency. *
Required
I understand photographs are used to record and promote Summer Camps and my child may appear in photographs used for such purposes. *
Required
Typing your name here constitutes a signature for all above information is true and accurate. *
A copy of your responses will be emailed to the address you provided.
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