EmailMe Form - 2024 Summer Camp Registration Form

Camper's Name *
First Last
Payment Options
$200 Deposit / $1,700 Due on July 1st.
$200 Deposit / $850 Due on July 1 / $850 Due on Aug. 1
MAIN 4 WEEK Camp (July 8th - August 2nd)
Parent's Name *
First Last
Date of Birth
MM / DD / YYYY
Grade Entering:
Billing Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Please enter the address that is on file with the card.
Phone Number *
### - ### - ####
Email *
.

Confirm
Emergency Contact *
First Last
Emergency Contact Phone Number *
### - ### - ####
I give my child permission to walk to lunch each day.
Please List All Allergies Your Child Has
Payment Details
Please provide payment details below
Credit Card

Card Number

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Authorization of Charges *
I do authorize
As named Cardholder; I Authorize: ***HTAC*** to immediately charge my credit card the above amount for the deposit. ($200)
Authorization of Future Payments *
I Authorize Future Payment of Remaining Tuition
I want to use a different card for Remaining Tuition
I will authorize By EMAIL, all future payments due towards HTAC Summer Camp, to be charged to the above credit card with the same terms as disclosed.
Cancellation Policies *
I understand that should I cancel my registration at any time, including after camp has started, the deposit / tuition is not refundable.
Medical Release *
I agree
I do not agree
All Campers are expected to follow all COVID-19 Pandemic Guidelines during rehearsals / performances, including having their temperature taken before enteringHTAC and wearing a face mask when necessary. Therefore, I release and hold harmless the Haddonfield Theater Arts Center, and any of its officers or staff, of any and all liability for any injuries or damages to me or my child, as a result of any function, rehearsal, or performance. Furthermore, all participants are physically fit (except as noted below) to participate in a theatrical production. I hereby authorize HTAC to act for me in a medical emergency in the event that I cannot be immediately contacted. I also hereby assume responsibility for payment of any treatment.

Payment Details