Consent Form | Screenwriting And St

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Youth Acting Summer Camp
About David
Media

YOUTH ACTING SUMMER CAMP

Participant Registration & Parent/Guardian Consent Form

Participants are expected to:

• Treat others respectfully

• Follow staff instructions

• Participate safely and positively

• Refrain from bullying or disruptive behavior

Failure to follow camp rules may result in dismissal from the program

Participant's Full Name*

Birthday*

Day

Month

Year

Age*

Parents Full Name*

Parents Phone Number*

Secondary contact in case of Emergency*

Does the Student have any allergies*

Yes

If yes, please write below*

Does the participant carry an EpiPen, inhaler, or medication?*

Yes

If yes, please explain*

Any medical conditions we should be aware of?*

Will the participant need to take medication during camp hours?*

Yes

If yes, please provide details and instructions:*

During camp, photos and video footage may be captured for promotional and educational purposes, including social media and website content.*

Yes

Please indicate how your child will leave camp each day:*

Participant may leave independently

Parent/Guardian Pick-Up

Approved Adult Pick-Up

Name(s)*

LIABILITY & MEDICAL CONSENT I understand that while every reasonable precaution will be taken to ensure participant safety, participation in camp activities involves some inherent risk. In the event of a medical emergency, I authorize camp staff to seek m*

I agree

PARENT/GUARDIAN SIGNATURE I confirm that the information provided is accurate and complete. Parent/Guardian Name: *

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