Summer Camp Registration

About the camper

First name:

Last name:

Date of birth:

Address line 1:

Address line 2:

For our reference

How did you hear about the summer camp?

Mother:

Mother's email address:

Mother's mobile phone number:

Father:

Father's email address:

Father's mobile phone number:

Consent

I give my consent that the administration of the Teremok theater uses photos and/or videos of my child taken at the summer camp. The images can be used in printed materials and/or published on the Internet.

I agree

Are you a robot?

Sidebar

About the camper

For our reference

Session(s)