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PARENTAL RELEASE AND INDEMNITY AGREEMENT

I request that you accept the application for enrollment of my child in the Mt. Vernon High School Summer Theater Camp for Kids sponsored by Thespian Troupe #804. In consideration of your acceptance of the application, I hereby release Mt. Vernon Township High School, all of it employees and student workers and volunteers from all claims on account of injuries which may be sustained by my child while attending this camp and I agree to indemnify Mt. Vernon Township High School, all of its employees, student workers and vol- unteers for any claim which may herein after be presented by my child for and such injuries. In the event of illness or injury I hereby give my consent for medical injections, anesthesia, or sur- gery. I will be responsible for any medi- cal and/or other charges in connection with my child’s attendance at the camp.

Student Name

First Name

Last Name

Guardian Name

First Name

Last Name

Please list additional adults who have permission to pick up your child

PLEASE LIST ANY ALLERGIES

Student Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Student Grade

Phone

(###)

###

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SHIRT SIZE

Checkbox

AM Session

PM Session

My child would like to participate in

Actor/Dance (In Scenes)

Stage Crew (Stage Hand)

Tech Crew (Spotlighter)

Registration Due Date May 25th

**Cost: 75$

**Late fee: $85

No “Day-of Event” Registry Accepted

Please pay via cash or check when your child registers the first day of camp, or pay CashApp ahead of time @ $MVTHStheater (include Child’s name when paying on CashApp).

ACTIVITIES INCLUDE

Costumes

Make-Up

Voice Projection

Improvisation

Dance/Music

Blocking

Motivation

Animation/Body Language

Audition Techniques

Theatre Tech (Lights, Sound)

Stage Crew (Set Design)

Rehearsals & Camp Show!

WHEN: Monday, June 2 through Thursday, June 6

Camp Performance: Thursday Evening at 6:30 pm

WHERE: Mt. Vernon High School Schweinfurth Theater

MORNING SESSION: Morning session is from 9:00 am- 12:00 pm for students entering grades 2,3,4,5 and 6.

AFTERNOON SESSION: Afternoon session is from 1:00pm-4:00pm for students entering grades 6,7,8 and 9.

For 6th graders:please indicate morning or afternoon session preference. We will make every effort to accommodate you.

Campers must wear closed-toed shoes to participate

What REALLY happens behind the curtain during a show? Join us to find out!

CAMP DIRECTORS

Raquel Bliffen, MVTHS Theater Director

Erin Coatney, Graduate of SIU Carbondale, Theater Department

Ready to Register?

Registration Due Date May 25th

ACTIVITIES INCLUDE

WHEN: Monday, June 2 through Thursday, June 6

Camp Performance: Thursday Evening at 6:30 pm

WHERE: Mt. Vernon High School Schweinfurth Theater

Campers must wear closed-toed shoes to participate