Youth Drama Camp Registration Form

Willy Wonka Kids
Youth Drama Camp Online Registration Form

* Indicates required field

Camper *

1st child *

Grade in Fall 2021 *

T-shirt Size *

2nd child in the same family *

Grade in Fall 2021 *

T-shirt Size *

3rd child in the same family *

Grade in Fall 2021 *

T-shirt Size *

4th child in the same family *

Grade in Fall 2021 *

T-Shirt Size *

Parent/Guardian Names *

Cell Number to be used for Group Text *

Secondary Phone Number *

Emergency Contact Person *

Phone Number *

Relationship *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Payment by May 15th *

Email *

I hereby release Gibson County Youth Theatre of liability for any accident/injury my child may incur while participating in the Youth Drama Camp. I give permission for my child's picture/video/likeness/voice to be used in promotional media.

Liability Waiver *

I accept

Please list any comments, special health or behavior concerns: *

Submit

YOU MUST CLICK SUMBIT ABOVE PRIOR TO MOVING ON TO PAYMENT.
Payment is a separate step.

ONLINE PAYMENT

For payment through PayPal, Click the "Buy Now" button:

SNAIL MAIL OPTION

Printable Camp Registration Form

Print the form above and mail it with payment to:

Gibson County Youth Theatre
Kathy Evans, Treasurer
P.O. Box 247
Patoka, IN 47666

Willy Wonka KidsYouth Drama Camp Online Registration Form

Willy Wonka Kids
Youth Drama Camp Online Registration Form