CenterStage Theatre Company

1153 Hillside Ct.

Louisville CO 80027

www.centerstagetheatercompany.org

Tel 303-673-9095

SUMMER CAMP 2008

Dairy Center for the Arts The Art Underground

2590 Walnut St 901 Front St

Boulder CO 80302 Louisville CO 80027

2 week( ½ day sessions) $270.00 2 week (full day) sessions $540.00

Session(s) your child wishes to attend (please circle)

Camps held at The Art Underground, Louisville

Session 1 (ages 7-11) 6/16-6/27 9:00am-12:00pm Musical Theatre Camp

Session 2 (ages 7-11) 6/16-6/27 1:00pm-4:00pm Musical Theatre Camp

Session 3 (ages 7-11) 6/16-6/27 12:00pm-1:00pm Supervised Lunch

( No cost for lunch hour if attending both morning and afternoon sessions, please bring sack lunch)

Camps held at The Dairy Center for the Arts, Boulder

Session 4 (ages 9-13) 7/7-7/18 9:00am-4:00pm Musical Theatre Camp

(bring sack lunch)

Session 5 (ages 7-10) 7/14-7/25 9:00am-12:00pm Intro to Musical Theatre

Session 6 (ages 11-14) 7/14-7/25 1:00pm-4:00pm One Acts Camp

Date_______________ Email_____________________________________

Student Name_______________________________________________ Date of Birth________

Grade___________________School_____________________________Gender M F (please circle)

Parent/Guardian Name_____________________________________Employer__________________

Parent/Guardian Name_____________________________________Employer__________________

Home Address_______________________________________City___________________Zip_______ 

Home Phone________________________Cell Phone__________________Work Phone_____________

If different from above, please provide the other parent or guardian’s information

Home Address_____________________________________City__________________Zip___________

Home Phone_________________________Cell Phone___________________Work Phone___________

Emergency Contact_____________________________Phone__________________________________

Student’s physician______________________________Phone_________________________________

Are there any medical concerns that we should be aware of? Yes No

If yes, please explain

Are there any food allergies? Yes No

If yes, please explain:

Are you new to CenterStage Theatre Co?______ How did you hear of us?_____________________

Student’s previous theater, dance, and music experience:

A non-refundable deposit of $100.00 per session is required to reserve space in CSTC’s Summer Camp Program. The remaining balance per session will be payable on the first day of the session. Please make checks payable to CSTC and mail your deposit to CSTC 1153 Hillside Ct. Louisville CO 80027.

By participating in CenterStage Theatre Company’s summer camp, I acknowledge that the activities may carry certain risks for the participant. I have independently reviewed and evaluated the risks and determine to allow my child to engage in the program with full knowledge and acceptance of the risks. I agree and do hereby release and forever discharge the Board and employees of CSTC, The Art Underground and The Dairy Center for Arts from any and all liability for damages, loss, or personal injury arising out of or related to participation in CenterStage Theatre Company’s summer camp. I understand that participants may be photographed during rehearsals or performances, and that these photographs may be used to publicize the activities of CenterStage Theatre Company and used on CSTC’s website, as they deem appropriate.

Parent/Guardian Signature:______________________________________________________________

Date________________________________________________________________________________