Camp Registration Form

SESSION DATE(s) & LOCATION(s):

Student Name:

Rising Grade & School:

Parent(s):

Address:

City: Zip:

Home Phone: : Cell Phone:

E-Mail:

Work Phone: Employer:

Any known allergies?

Emergency Contact Names and Numbers:

Health Insurance Policy and Number:

Please list any previous theatre training classes/camps,how long, & where:

T-Shirt is an additional$12 Please circle size: child small child medium adult small adult medium adult large

Advanced Campers must attach a headshot & resume with the Registration Form.

PARENT CONSENT AND AGREEMENT—Please read carefully and sign:

I agree to place my child(ren) in The Metropolitan Theatre Conservatory Summer Camp program held at the Davis Academy, Hopewell Middle, and Centennial High School.

I agree to the policies and procedures outlined and understand that tuition is non-refundable also give consent for my child to be photographed, videotaped, and/or interviewed for publication/broadcast and to be used in conjunction with PR activities, press releases, and articles on behalf of Kendrick & Company’s MTC.

In placing my child(ren) in this program, I fully understand and agree to hold The Metropolitan Conservatory, and its instructors and administrators, the Davis Academy, Hopewell Middle, & Centennial High School free from any liability , costs and claims arising from any injury, illness, and/or claims in the program provided. Should my child(ren) need medical attention, I understand every effort will be made to contact me. If I cannot be reached, I give my permission for my child(ren) to be treated by a competent physician and to receive emergency medical treatment.

Signed:................................................................................................Date:................……

PLEASE MAKE CHECKS PAYABLE TO & MAIL TO:

METROPOLITAN THEATRE CONSERVATORY, Inc.

P.O. Box 889082 Atlanta, GA 30356

Questions? Please call the office at 770.394.1461

www.metropolitanconservatory.com