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Civic Youth Theatre

2012 Summer Camp Registration Form

Camper First Name: *

Camper Last Name: *

Camper Age (as of first day of selected camp) *

Parent/Guardian First Name *

Parent/Guardian Last Name *

E-mail Address: *

Day Number: *

Evening Number:

Street Address: *

Address Line 2:

City: *

State: *

Postal Code: *

Select Camp(s) Registration *

Acting with Improv - Session 1 June 11-15, 9:00 AM - 3:00 PM (Ages 8 - 12) $150 SOLD OUT
Acting with Improv - Session 2 - June 18 - 22, 9:00 AM - 3:00 PM (Ages 8-13) $150
I Love Theatre - June 25 - 29, 9:00 AM - 12:00 PM (Ages 5 - 7) $75
Curtain Up Summer Camp - G2K Oklahoma - (July 2 - 27, performances through July 29, 9:00 AM - 5:00 PM (Ages 9-13) $400
Broadway Bound Summer Camp - Guys and Dolls - July 2 - 20, 9:00 AM - 5:00 PM (performances July 20 & 21) (Ages 14 - 18) $350

Are you interested in Before or After Care for your camper? *

Yes
No

Are you a Member of Civic Theatre (discounts are available for Members and for multiple campers. Discount will be reflected on invoice. *

Yes
No

Comments / Questions:

* Required

Civic Theatre
313 North 5th Street *
Lafayette, IN 47901
Phone: (765)423-PLAY * Fax: (765)742-7247
e-mail: info@lafayettecivic.org

Last Revised April 06, 2012