CAMP TALENT SIGN UP BELOW

MOVING MOUNTAINS

CAMP TALENT 2024

Camp Talent is a fun filled summer with a heavy focus on talent development! Each day consist of physical exercises, summer reading, drama, dance and vocal classes. Every Thursday is a fun day!

Please completely fill out this registration form.

Dates: July 8th - August 15th, 2024

Location: PS 20 The Clinton Hill School

Address: 225 Adelphi St, Brooklyn, NY 11205

Mondays through Thursdays

Time: 830am to 4pm drop off is possible at 8am

Ages: 6 - 13

Please submit a separate form for each child.

First name

Last name

First and Last Name

Phone

Childs Phone Number

Please Enter Childs DOB

Please Enter your Childs Address

What grade will your child be attending in the fall?

Name of your Childs school

What is your Childs Osis Number

EMERGENCY CONTACT 1 NAME & RELATIONSHIP

EMERGENCY CONTACT 1 #

EMERGENCY CONTACT 2 NAME & RELATIONSHIP

EMERGENCY CONTACT 2 #

Please list any allergies, health issues and physical limitations if any.

Please list any medications we should be aware of. We are not responsible of giving medications

Upload Recent Physical

I give my child permission to attend Moving Mountains Inc Theater Company Camp Talent Summer 2024.

PARENT/GUARDIAN AGREEMENT I, the undersigned, give permission for my child to participate in all summer camp activities for the days he/she attends. I also hereby give authority to Camp Talent staff to obtain necessary emergency medical treatment for my child with the understanding that the family will be notified as soon as possible.

I understand there will be a late pick up charge of $20.00 for the first 15 minutes and $1.00 per minute for each additional minute. Anyone picking up your child, must be 18 years of age or older. Please make sure all information is up to date (i.e. phone numbers and address) for individuals authorized to pick up your child.

I give permission to allow my child to attend all scheduled trips and out of camp activities under supervision of the camp staff. I allow for my child to be given professional medical treatment in the case where the emergency contact person cannot be reached. I give Camp Talent permission to take and publish photographs, video and voice of my child in any media for any legitimate purpose. I release all rights to such photographs, video and recordings.

I acknowledge that Camp Talent will be the sole owner of rights arising out of their use for all purposes and understand that neither my child nor I shall receive compensation. I agree to all above listed conditions.

Campers are not allowed to bring valuables to camp. (i.e. cameras, video games, jewelry, etc.) Camp Talent assumes no responsibility for lost or stolen items. Campers are only allowed to bring healthy snacks to camp (No soda, candy, sugary sweets). Summer students, parents and relatives agree to abide by the rules and regulations set by the camp for the health, safety and welfare of the camp. Medical forms are due within the first week of camp.

Registration Fee is $40. An invoice will be sent to your email and registration will be confirmed upon reciept of payment.

Signature