Camper's Name *

First Name

Last Name

Camper's Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Phone Number *

Please list the best phone number for us to reach you.

(###)

###

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Second Parent/Guardian Name

If applicable

First Name

Last Name

Second Parent/Guardian Phone Number

If applicable

(###)

###

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

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How did you hear about our theatre camps? (please select all that apply) *

Referred by family/friend

Flyer or Pamphlet

Online Search for children’s theatre opportunities

During ACT camps/camp shows

Program for an ACT show

Email

ACT website

Event or Curriculum Fair Booth

Peachjar

familyeguide.com

Macaroni KID

Crosstimbers Gazette ad

Facebook

Instagram

Snapchat

Other*