Please Fill out this form in it's entirety! Your child is not registered until

Liability Waiver and Code of Conduct Forms are signed!

Student First name

Student Last Name

Student Date of birth

Month

Day

Year

Please List All Camps you would like to register this student for, including grade level if applicable (if a camp is offered for two different grade levels!)

Parent/Guardian First and Last

Parent/Guardian Email

Parent/Guardian Phone #

Country/Region

Address

City

Zip / Postal code

If you would like to register (a) sibling(s), please put their First and Last Name, Age and ALL camps registering for in this spot.

How did you hear about us?

I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER PARTICIPATION, AGREEMENT, LIABILITY WAIVER, AND POLICY ACKNOWLEDGEMENT,

https://www.imagineperformingartscenter.org/liabilitywaiver

By signing, I acknowledge that I have read, understood, and agree to all the terms and conditions stated in this agreement.

I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER STUDENT CODE OF CONDUCT

https://www.imagineperformingartscenter.org/codeofconduct

By signing, I confirm that I have read, understood, and agree to the student code of conduct, and I am aware of the consequences of not adhering to it.

Emergency Contact Name

Emergency Contact Phone

Registration Fee - please choose according to how many students/camps you are registering (for example, add 2 Deposits to your cart if you are registering for two camps or two students). The same goes for the early drop-off/late pickup

Deposit for One Camp/One Student$50

Early Drop-Off OR Late Pickup$30

Early Drop Off AND Late Pickup$50

I would like to donate to another child's tuition

Register For Summer!

Please Fill out this form in it's entirety! Your child is not registered until

Liability Waiver and Code of Conduct Forms are signed!