Peacock Players STC 2019 Registration Form
Campers aged 8-18

Mondays through Fridays 9:00AM-5:00PM

Act One Camp: July 8-July 20
Showcase Performance: Saturday, July, 20

Act Two Camp: July 22-August 3
Showcase Performance: Saturday, August, 3

For more information please contact education@peacockplayers.org or call (603) 816-2695.

Session *
Student Last Name *
Your answer
Student First Name *
Your answer
Student Age (During Camp) *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade Completed *
Your answer
Gender *
T-Shirt Size *
Grouping Requests
Please list below the names of any Summer Theatre Camp enrolled friends you would like to be grouped with. PLEASE NOTE: Summer Theatre Campers are primarily divided into groups by age, birthdate and/or school grade -we will do our best to accommodate your grouping requests, but they are not guaranteed.
Your answer
What are some of your student's goals or objectives while attending our Summer Theatre Camp?
Your answer
Tell us about your student's previous performance experience? (Eg. Theatre, Dance, Choir, Band, Gymnastics, School plays).
Your answer
Does your student have any specific needs of which you would like us to be aware?
Your answer
Home Address *
ex: 14 Court St, Nashua, NH, 03060
Your answer
Parent #1 Name (Primary Contact) *
Your answer
Parent #1 Email *
Your answer
Parent #1 Phone Number *
Your answer
Parent #2 Name
Your answer
Parent #2 Email
Your answer
Parent #2 Phone Number
Your answer
Payment Options *
Do you agree to Peacock Players Summer Theatre Camp terms and agreements? *
Please read these terms and agreements carefully. This is considered a contract and your electronic signature below indicates that you have read and understand every provision of these terms and agreements and that you unequivocally agree to all terms, conditions and promises herein. The payment of your deposit further verifies your agreement to the terms of this agreement. https://docs.google.com/document/d/1TO3923qSJ7DIWTpnAkWKCYzFdNtEmzQuf-Iqa2vM7kM/edit?usp=sharing
Electronic Signature *
Your answer
Are you registering a second camper? *
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