Registration Form - SouthWest StageWorks BootCamp
We are taking Registrations for the 22-23 (SW)2 BootCamp either onsite or in advance, via this Google Form.  Feel free to use either!  We're happy to have you back this summer!

Camp fee of $50, to help kickoff this SouthWest StageWorks season, will be payable at the door.  Cash or Check only...sorry for any inconvenience!
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Email *
Student Name *
Age *
Pronouns Used *
If Student uses pronouns other than those above, please let us know what they are below!
School Student's attending this coming year (22-23): *
Grade in school for Student this coming year (22-23): *
School Student attended last school year (22-23) *
Student will be taking the Company Basics sequence (see southweststageworks.com/sw2-bootcamp for details) *
Student has permission to come/go as they wish/need: *
Student has permission to leave campus for lunch between 1130a and 1230p: *
Primary Parent/Guardian Contact - Name *
Primary Parent/Guardian Contact - Phone Number *
Primary Parent/Guardian Contact - email address *
Additional Parent/Guardian Contact - Name
Additional Parent/Guardian Contact - Phone Number
Additional Parent/Guardian Contact - email address
Alternate Emergency Contact - Name *
Alternate Emergency Contact - Relationship to Student *
Alternate Emergency Contact - Phone Number *
Allergies/Health Conditions for us to be aware of (please enter 'none' if none exist: *
Given the current state of public health guidance and county/state requirements, there will be no expectation that anyone taking part in the BootCamp need wear masks while indoors on the Ida B. Wells-Barnett (IBWHS) campus, unless so desired by family, though will certainly be supported by all on site.  With large spaces and good ventilation, families should rest assured about minimal transmission possibilities.  

Additionally, there will be interactions with tools, theatrical rigging, and sewing equipment, as well as physically exerting activities....while there will be strong supervision, which must be followed at all times, there is always the small chance of injury.  Should that happen, an incident report will be filed with PPS by Mr. Miller and parent/guardian contact will occur.

Finally, the water outlets are currently under refurbishment at IBWHS.  There is limited access to drinking water.  Please make sure students bring hydration for the longish days!

Please acknowledge below that you have read the above cautions and accept these Camp guidelines.  
 *
Required
As part of our work to grow our program in the SW Portland/IBWHS Community, we will be taking photos of the activities in progress for publicity and celebration purposes.  Please let us know below if your student's image is cleared to be used strictly for archival purposes or sharing (SW)2 work with our community. *
Required
Parent/Guardian Name (in lieu of registration signature) *
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