LOW Players Theater Camp Registration
June 12 - June 16 2023 from 9:00 am - 3:30 pm at the LOW Community Center
Complete the registration form and submit. 
Our Camp Directors will be in touch after they receive your registration. 
They will confirm your registration and give you direction on paying camp tuition online. No refunds on fees.
Please do not try to pay for your camp tuition before you receive confirmation from our Camp staff. 
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Email *
CAMPER INFORMATION
First and Last Name *
Does the camper have a preferred nickname? *
Does the camper have a preferred pronoun? *
Age *
Grade in school *
T-shirt size *
PARENT/GUARDIAN INFORMATION
First and Last Name *
Email *
Address *
Cell Phone number *
Alternate Phone Number *
EMERGENCY CONTACT 
Emergency Contact's First and Last Name *
Relationship to camper *
Required
Emergency Contact's  Phone Number *
Emergency Contact's  Alternate Phone Number *
Emergency Contact's Email Address *
PEOPLE other than parents/guardians AUTHORIZED to pick up camper.
Authorized people's First and Last Name  *
OTHER INFORMAITON
Please list any other information you would like us to know about your camper.
 *
PHOTOGRAPHY AUTHORIZATION
We may take photographs during the camp to use for a LOW Lake Currents article or other publicity to show the hard work and fun the campers had during the week. 

As the parent or legal guardian of a camper, I grant LOW Players my permission to use the photographs from the LOW Players Camp for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.

Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.


 *
MEDICAL INFORMATION
If your child needs medicine during camp, please bring it clearly labeled with their name in a Ziplock plastic bag.

Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe. *
Is the camper prescribed an inhaler or any medications needed during camp hours? If yes, please explain any instructions.
 *
MEDICAL RELEASE AND AUTHORIZATION

As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor child, if delayed.

This authorization is granted only after a reasonable effort has been made to reach me.

This medical release is authorized on June 12 through June 16, 2023 for the duration of the registered camp week.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

 *
CONSENT

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by during the LOW Players Theater Camp. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless LOW Players Theater Camp, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against LOW Players Theater Camp including all instructors and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. 

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CONFIRMATION
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
 *
Date of signature *
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