Registration Form for Missoula Summer Camp
Our summer week-long camp will be held June 14-19, 2010; at Valdosta High School’s Performing Arts Center, 3101 N. Forrest St. Valdosta, GA.
The production this year is “The Princess and the Pea”. It promises to be another great experience. Complete this form and send it with your payment to Little Actor’s Theatre: P.O. Box 3601 Valdosta, GA 31604.
Name: __________________________________________________________________________
Age: ______ Birthday_________ Grade (must be entering 1st grade)_____
Address:_________________________________________________________________________
__________________________________________________________________________
Phone numbers (H)_____________________ (c)_________________________
E-Mail:_________________________________________________________________________
Parents Names:__________________________________________________________________
Enclose payment of $90.00 if post-marked before 5/15/2010, or $100.00 for payments after that date.
Cash_______Check_______ Money order______
Does your child have any special needs we should be aware of?___________________________________ ______________________________________________________________________________________