Camper Name *

First Name

Last Name

Phone *

(###)

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Additional Phone

(###)

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Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Total camp fee is $125 prior to April 1 ($150 April 1 and after). How will you submit payment of the $62.50 deposit? *

Balance is due on the first day of camp

Paypal - @hpct

Venmo - @HighPoint-CommunityTheatre

Check - make payable to High Point Community Theatre - mail to: HPCT, PO Box 1152, High Point, NC 27261

AGREEMENT, RELEASE FROM LIABILITY, WAIVER OF CLAIMS & ASSUMPTION OF RISK *

I agree to pay all participation fees. I, on behalf of myself, my heirs, executors, agents, assigns, and representatives, hereby indemnify, release and forever hold harmless High Point Community Theatre, a not-for-profit corporation, as well as its directors, employees and instructors, from any and all claims of liability arising from any accident, personal injury, death, or property loss or damage sustained by my child/myself/the minor child for whom I am a legal guardian, while that person is participating in activities connected with High Point Community Theatre, including classes, rehearsals, performances, or other activities. I understand that these activities have inherent risks of injury, and, being fully aware of all risk, I consent to have myself/my child/the minor child for whom I am a legal guardian, participate in the programs and activities offered by High Point Community Theatre and I accept full responsibility for providing adequate health and accident insurance coverage for the protection for myself/my child/the minor child for whom I am a legal guardian. I understand that this is an assumption of risk and release of liability, and I sign it of my own free will. If I am signing this in my capacity as the legal guardian of a minor child, I authorize High Point Community Theatre to use photos and videos of the minor child for promotional purposes. I authorize High Point Community Theatre to use photos of myself for promotional purposes. I understand that I/my child will have certain behavioral and participation requirements. If these requirements are not met, Camp Administrators reserve the right to remove them from the camp.

Checking this box indicates that I agree to the above statements & will be considered an electronic signature submitted on the date that the "Submit" button is clicked.

I do not agree (your registration will be invalid - please email us at hpct.info@gmail.com if you would like to discuss this).