MCHS Mustang Drama Rising Stars Theatre Camp

MCHSMustangDramaRisingStarsTheatreCamp
Whocanparticipate:Anystudentinterestedinfurtheringtheirtheatreexperiencethis
summerandthatareenteringintogrades1-12forthe2016/2017schoolyear.
Datesoftheevent:June27-July8(noweekendsandno4thofJuly)
Timesofevent:Forstudentsgrades1-5(goingintogrades)campwillbefrom8:00am-12:00pm
Forstudentsgrades6-12(goingintogrades)campwillbefrom2:00pm-6:00pm
Location:ThecampwilltakeplaceonthestageoftheFelixE.MartinJr.Hallat501RobertL.
DraperWayinGreenville.
DetailsoftheCamp:TheRisingStarTheatreCampenablestheater-lovingkids,grades1-12,
todeveloptheirconfidence,characterandpresentationskillsthroughensemble
performance.Ourstaffwillimmerseyourchildinanauthenticrehearsalandproduction
processthatallowsallcamperstobesuccessfulregardlessofexperiencelevel.RisingStar
TheatreCampisdesignedtobuildconfidence,inspirecreativeexpression,andinstillwellbeinginbothaspiringartistsandfutureaudiences.
WewillconcludethecampwithapresentationontheeveningofJuly8that6pmwhere
familyandfriendscancometoseetheproductionthatthecampersworkedhardto
prepare.Wehopeyoucanjoinusforthisfunfilledcamp!
RegistrationForms:FormsareduebyJune25th.PleasebringtheformtoWestCampusor
mailto:FelixE.MartinJr.Hall,501RobertL.DraperWay,Greenville,KY.42345
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Datesofcamp:June26 -July8 ,2016Grades1-5:8:00-12:00Grades6-12:2:00-6:00
Thecostofcampis$30perchild,$15foreachadditionalsibling.
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MakecheckspayabletoMuhlenbergCountyHighSchool.DeadlineforformsandmoneymustbepostmarkedbyJune26 BringthisformandtheattachedwaiverofliabilitytothefrontofficeofWestCampusormailto:
FelixE.MartinJr.Hall,501RobertL.DraperWay,Greenville,KY.42345
CamperName:_________________________________________Age:______T-ShirtSize:______
MailingAddress:______________________________________________________________________
School:_________________________________________Grade:_______Gender:_______Race:_________
Pleaseputthegradethatyourchildwillbeinthe2016/2017schoolyear
CustodialParent/Guardian:____________________________Phone:____________Cell:__________
Email:______________________________________________________________________________
Pleaselistifthereisanythingthatyouwouldlikeustoknowthatwouldbetterhis/herexperiencewiththe
theatrecamp
_________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
MedicalInformation&Allergies(Attachadditionalpageifnecessary)
____________________________________________________________________________________
IfIamunabletopickmychildupfromcamp,thepersonlistedbelowhasmypermissiontodoso:
Name:_____________________________________________Phone:____________Cell:__________
Address:____________________________________________________________________________
Relationship:_________________________________________________________________________
IfIamnotavailableinanemergencypleasenotify:
Name:_____________________________________________Phone:____________Cell:__________
Address:____________________________________________________________________________
Relationship:_________________________________________________________________________
PhotoUsePermission
IgrantMCHSMustangDrama,andpersonsactingthroughthem,therighttouse,reproduce,assignand/ordistribute
photographs,films,videotapes,andsoundrecordingsofmyminorchildwithoutcompensationforusein
promotion/advertising,educationalpublications,orelectronicpublishing(website)whichtheymaycreate.Children’snames
willnotbepublished.
Signatureofparent/guardian:___________________________________________________Date:_______________
AcknowledgementofRiskandWaiverofLiability
NameofChild(ren)participant(s)(ifunderage18):________________________________________________
Nameofadultparticipant/parent/legalguardian:_________________________________________________
Asalegalguardianof______________________________,Iherebyconsenttotheaboveperson(s)in
participatingintheMCHSMustangDramaRisingStarsTheatreCamp.Irecognizethatpotentiallysevere
injuriesincludingbutnotlimitedtopermanentparalysisorevendeathcanoccurduringanyphysicalactivity.I
alsorealizemychild(ren)willbeperformingdifferentphysicalactivitiesduringthecampprogram.
IunderstandthatitistheexpressedintentoftheMuhlenbergCountyHighSchoolMustangDramato
provideforreasonablesafetyandprotectionofme/mychild(ren)andinconsiderationforallowingme/my
child(ren)toparticipatingintheRisingStarsTheatreCampprogram,Iherebyformyself,heirs,executorsand
administrators,foreverreleaseMuhlenbergCountyHighSchooland/orDavidProbusandLeslieEngland,
VictoriaMartin,MakalaWright,boardmembers,groupleaders,andallthoseassistingwiththiseventfromall
liabilitiesforanyandalldamagesandinjuriessufferedbyme/mychild(ren)whileparticipatinginthisevent.
Ialsocertifythatme/mychild(ren)is/areandwillremaincoveredbyAdequateAccidentInsurance
Programcoveringme/mychild(ren)’sparticipationintheRisingStarsTheatreCamp.Asalegalguardianofthe
aforementionedperson(s),Iherebyagreetoindividuallyprovideforthepossiblefuturemedicalexpenses,
whichmaybeincurredbyme/mychild(ren)asaresultofanyinjurysustainedwhileparticipatingintheRising
StarsTheatreCamp.
Thisacknowledgementofriskandwaiverofliability,havingreadthoroughlyandunderstood
completely,issignedvoluntarilyastoitscontentandintent.
PermissiontoTreat:
Iherebygivemypermissiontotrainedmedicalprofessionalstoadministeremergencymedical
treatmenttomychild(ren)shouldsicknessoccurinmyabsence.
Signatureofparentorlegalguardian_____________________________Date__________________