School Break Camp Registration

Student Gender *
PARENT #1 INFORMATION
PARENT #2 INFORMATION
ADDITIONAL PICK UP PERSON(S)
Unless indicated here, only Parent 1 and Parent 2 will be able to pick this student up from camp. Please use this section to list any additional people who have permission to pick up this student. 
EMERGENCY CONTACT
(Other than Parent)
I hereby grant permission for kidsActing to use my child's likeness (in photos) for future publications, social media, and/or photo galleries on our website. *