Camp Registration Form

Name of Camp Week

Attendee First name

Attendee Last name

Preferred Pronouns

Date of Birth

Month

Day

Year

T-Shirt Size

Address

Parent(s)/Guardian Name

Parent(s)/Guardian Phone Number

Parent(s)/Guardian Email Address

Medical Release Information/Consent for Treatment (CCT does NOT carry insurance for students.)

YES, 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

Physician Name/Number

Insurance Information

Allergies (If None enter None)

Medications or Conditions

In Case of Emergency Contact Information

I understand photographs are used to record and promote Summer Camps and my child may appear in photographs used for such purposes.

Yes

Who will be picking up Youth/Teen from camp?

Typing your name here constitutes a signature indicating you understand your camper is in an age-appropriate camp.

Typing your name here constitutes a signature for all above information is true and accurate.

Camp Registration Form

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