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Fall Break Arts Camp Registration 2024

Welcome to the Rising Youth Theatre Arts Camp!

Before the first day of your young person's camp session, please complete the following two actions:

1. Review the Arts Camp Parent/Guardian Policies and Information Packet here

2. Register your young person for camp by filling out the form below. In this form, confirm you've reviewed the Policies and Information Packet and share any important information about your young person so we are ready to have a great camp session. Please note that your young person cannot participate in any activities until this form is completed in full.

If you would like to request a scholarship or sliding scale price, please fill out the scholarship registration form instead of this one and we will contact you directly! We try very hard to accomodate all requests and we will work with our community to ensure access to our programming

If you have any questions, please contact Camp Director Ty Muhammad at: ty@risingyouththeatre.org

Caregiver Information

Contact information for the adult responsible for this camper

Name *

First Name

Last Name

Email *

Verify Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Second Caregiver Information

Name

First Name

Last Name

Phone

Verify Email

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Camper Information

Which session(s) is this camper registering for? *

Fall Break Camp - October 7 - 11, 2024

Name *

First Name

Last Name

What would your young person like to be called in class?

If different than first name

Birthdate *

(mm/dd/yyyy)

Age *

Pronouns

how your camper would like to be identified (for ex. he/him, they/them, she/her)

Is there anything you would like us to know about your young person before Camp so that we can best support them?

For example, an IEP at school, learning needs, medical information, etc.

Camper 2: Which session(s) is this camper registering for? *

Fall Break Camp - October 7 - 11, 2024

Camper 2 Name *

First Name

Last Name

Camper 2 What would your young person like to be called in class?

If different than first name

Camper 2 Birthdate *

(mm/dd/yyyy)

Camper 2 Age *

Camper 2 Pronouns

how your camper would like to be identified (for ex. he/him, they/them, she/her)

Camper 2 Is there anything you would like us to know about your young person before Camp so that we can best support them?

For example, an IEP at school, learning needs, medical information, etc.

Camper 3: Which session(s) is this camper registering for? *

Fall Break Camp - October 7 - 11, 2024

Camper 3 Name *

First Name

Last Name

Camper 3 What would your young person like to be called in class?

If different than first name

Camper 3 Birthdate *

(mm/dd/yyyy)

Camper 3 Age *

Camper 3 Pronouns

how your camper would like to be identified (for ex. he/him, they/them, she/her)

Camper 3 Is there anything you would like us to know about your young person before Camp so that we can best support them?

For example, an IEP at school, learning needs, medical information, etc.

Photo and Video Release

I authorize Rising Youth Theatre to document the process of work my young person is associated with as a part of Rising Youth Theatre’s Summer Arts Camp. Rising Youth Theatre will use photo and video in promoting this project, telling stories about the work of the Camp(s), marketing, archival, and publicity purposes. These photos and video will only be used in association with Rising Youth Theatre's organizational activities. Rising Youth Theatre will never sell images collected within a program.

By typing my full name below, I am signing this Photo Release. I acknowledge that I have read the policies and release and understand all of its terms. I execute it voluntarily and with full knowledge of its significance. *

If I do not comply, please write N/A and send an email to Ty@risingyouththeatre.org to confirm.

Waiver and Release

1. I understand that this is a multi arts experience. My young person may be trying new art forms for the first time. I will encourage my young person, in collaboration with Rising Youth Theatre (RYT) staff and instructors, to try all the class experiences, even if it is new. 2. I understand and take responsibility to ascertain that there is no medical reason to prevent my young person's participation in any arts related activities. I understand that physical activity does have inherent risks. I agree that RYTs directors, officers, representatives, owners, partners, employees, successors, instructors, and agents shall not be liable or responsible for any and all risk, damage, injury, or death which may occur as a result of (a) my child’s use of all amenities and equipment provided by RYT and/or (b) my slipping and/or falling while in the facility, or on other premises of RYT’s, including adjacent sidewalk areas. 3. I agree that RYT is not responsible for any loss of, or damage to my or my child’s personal property. 4. I expressly agree to release and discharge RYT’s subsidiaries, affiliates, directors, officers, representatives, owners, partners, employees, successors, instructors, and agents from any and all claims or causes of action that may arise and agree to voluntarily waive any right that I may otherwise have to bring a legal action against RYT for personal injury or property damage, except if arising out of the negligence or willful misconduct of RYT. To the extent that applicable laws do not prohibit release for ordinary negligence, this release applies to any ordinary negligence on the part of RYT, its agents, officers, directors, and employees. 5. I agree that I will not assert or maintain against Rising Youth Theatre, its successors, assigns, and licensees, a claim, action, suit, or demand of any kind or nature whatsoever, including but not limited to, those grounded upon invasion of privacy, rights of publicity or other civil rights, or for any other reason in connection with your authorized use of the photographs. I hereby release Rising Youth Theatre, its successors, assigns, and licensees from any and all such claims, actions, causes of action, suits, and demands whatsoever that I may now or hereafter have against Rising Youth Theatre.

By typing my full name below, I am signing this Waiver and Release Agreement and understand that it is a RELEASE OF LIABILITY. I execute it voluntarily and with full knowledge of its significance. *

Consent for Care

I give my consent for the above named child/children to receive emergency medical or dental treatment in the care of a physician and/or hospital or clinic. I understand that per RYT’s policies and procedures in the case of any life threatening or serious emergency, RYT and its staff will always call 911 first. I have received a copy of the arts camp information and policies and have read, understand, and agree to all content and policies.

By typing my full name below, I am signing this consent for care document I acknowledge that I have read the policies and release and understand all of its terms. I execute it voluntarily and with full knowledge of its significance. *

If I do not comply, please write N/A and send an email to Ty@risingyouththeatre.org to confirm.

Other Important Info

Please list the name and phone number for all adults who are allowed to pick up your young person from camp. Your young person will only be released to the care of people on this list. You can update this list at any time by emailing us.

In an emergency situation, who should we call first?

Payment Information

Please select all sessions you are registering for. If you are registering more than one camper please make sure to indicate more than one when making your selections

PROMO CODE

if you have a promo code, enter it here!

Camp Registration *	Quantity
$200 - Fall Break Arts Camp

Camp Registration - School Partner Discount *	Quantity
$100 - 1/2 off Arts Camp

Camp Registration - Returning Discount *	Quantity
$175 - $25 off Arts Camp

Camp Registration - Osborn Discount *	Quantity
$175 - $25 off Arts Camp

Extended Care	Quantity
$25 - Early Bird, M-F, 8am - 9am
$50 - Night Owl, M-F 3pm-5pm