Young Actors' Theatre Camp

Young Actors'
Theatre Camp

Discover and Develop
the Artist Within!

Your Subtitle text

Winter Holiday Break Camp
December 27, 2010 - January 2, 2011

YATC Winter 20010/11 Camp Registration

Please fill out the information below and submit for our records. You may pay online with a credit card by clicking on the PayPal Button below this form, or pay by check as outlined below.

Please e-mail the PayPal Confirmation Number (once you have it) to:
registration@youngactorstheatrecamp.org

Spaces marked with an asterik (*) are required.

Student's First Name*
Student's Last Name*
Student's Gender*
Student's Age*
Student's Birth Date*
Parent/Guardian #1 First Name*
Parent/Guardian #1 Last Name*
Parent/Guardian #2 First Name
Parent/Guardian #2 Last Name:
Home Phone*
Parent/Guardian #1 Cell or Work Phone*
Parent/Guardian #2 Cell or Work Phone
Street Address*
Apartment Number
City*
State*
Zip Code*
Student's E-mail
Parent's E-mail*
Emergency Contact Other Than Parent
First Name*
Last Name*
Contact Phone*
Relationship
Student's Medical History
Student's Medical History		Please list any pertinent medical information here.
Current Medications
Any Allergies
Special Dietary Needs
T-Shirt Size

Student's School*
Referred By
Specific Bunk Request, Insert Friend's Name Here

Refer a Friend! If they come to camp you get $50!!
Friend's Name
Friend's E-mail
What would your student like to get out of attending the Young Actors' Theatre Camp?		Please answer this question fully and to the best of your ability. It allows us to see you as an artist, triumphs and challenges.
Sending Check by Mail? Check Here
Paying Via PayPal? Check Here
Payment must be received within 7 days or space will be forfeited.

Call (925) 858-3548 with any questions.

Checks should be made out to "Young Actors Theatre Camp"
Full tuition is required to guarantee your student a space.

Pay only $1095!

Full Tuition is $1195

Or Send Check Payment to:

Young Actors' Theatre Camp
P.O. Box 461324
West Hollywood, CA 90046

A Fee of $25 will be assessed on all Returned Checks.
Registration Cancellation Policy:
90 days or more, Full Refund less $25 processing fee.
60-90 days, Partial Refund, less $150 processing fee.
30-60 days, Partial Refund, less $250 processing fee.
30 days or less, Tuition is Non-Refundable but may be transferrable
to another upcoming program, at management discretion.