2019 SESSION I & II REGISTRATION
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1 2019 SESSION I & II REGISTRATION Mail To: 1409 National Park Drive Manteo, North Carolina Or Fax (with credit card information) to: (252) Phone: (252) Website: Camp Hours: Camp Performance: 9:00am 3:00pm, Monday through Friday 3:00pm Friday Please check the appropriate session(s): Session I: Rising 1 st Graders 9 years old / June 24 June 28 (5 days) - $ day camp experience ending with a performance for friends and family. Session II: Rising 1 st Graders 10 years old / July 8 - July 12 (5 days) - $ Camper Information Camper Information Name Preferred Name Male Female Mailing Address City State Zip Code Age Grade Next Fall Does child enjoy school? Birthday (Month/Day/Year) Dietary Restrictions Is your child currently taking any medications? Yes No Attended Day Camps before? Number of years Attended The Lost Colony Theatre Day Camp before? How many years? List Clubs and/or organizations your child is interested in Child s special interests / hobbies PAGE 1 of 5
2 Camper Info Continued List special skills/values you seek for your child at our camp (be specific) How did you hear about our camp? Newspaper Website Friend Other : T-shirt Size: ADULT:Small Medium Large XL CHILD:Small Medium Large XL Parent/Guardian Information Parent/Guardian Parent's Business Home Phone Business Phone Cellular Phone Cellular Phone #2 address Emergency Contact Information Name Employer Home Phone Business Phone Cellular Phone address PAGE 2 of 5
3 Session fees include: T-shirt Snacks Attend performance of The Lost Colony s Children s Show 1 voucher for The Lost Colony RIHA Members receive $10 off each registration! Total : Payment Information A $45.00 non-refundable deposit is required for each session with the application. This deposit will be applied to the session fee. Please pay by check or credit card. All balances are due no later than the first day of camp. A processing fee of $35 will be charged for returned checks. Credit Card Information MasterCard Discover American Express Visa Card Number Expiration Date Name on Card (PLEASE PRINT) Authorized Amount Authorized Signature Date PAGE 3 of 5
4 2019 Parent or Guardian Agreement I agree the Roanoke Island Historical Association is released from liability in connection with medical treatment and unavoidable accidents. The Roanoke Island Historical Association also has my permission to use necessary medical measures in the event of an emergency. I fully understand the inherent risks involved in the activities my child will be choosing or has chosen. I accept all risks including those activities preliminary and subsequent to the chosen activity. Also, I give the Roanoke Island Historical Association permission to utilize my child s photograph or likeness in camp promotional materials. I understand that I must be present the first morning of camp, from 8:45am to 9:00am to meet the camp staff and establish my identity as the child s parent or guardian. I understand that I must sign my child in at the beginning of the day and sign them out at the end of each day. I also understand that if another individual will pick up my child that I must communicate this to the camp staff in advance. Parent or Guardian Signature Date PAGE 4 of 5
5 2019 THEATRE DAY CAMP INFORMATION 1409 National Park Drive, Manteo, NC Office (252) Fax (252) Website: SESSION I & II - Rising 1 st Graders 9 years old June 24 June 28 (5 days)....$ participants July 8 July 12 (5 days)....$ participants LOCATION The camp will be conducted in and around the facilities at the Waterside Theatre and the Lost Colony Building located in Fort Raleigh National Park in Manteo, North Carolina. REGISTRATION AND FEES *Fees include all activities, snacks, 1 T-shirt, attend a performance of the 2019 TLC Childrens Show, and 1 voucher good for 1 ticket for The Lost Colony. Complete application and mail to The Lost Colony Theatre Day Camp, 1409 National Park Drive, Manteo, NC or fax (252) or submit by to lculpepper@thelostcolony.org. All registrations must include a $45 deposit for each session which will be applied to the session fee. Campers may not enroll for a portion of a session. The remaining balance of camp fees is due no later than the first day of the session. Please make checks payable to Roanoke Island Historical Association. A $35 processing fee will be charged for all returned checks. VISA, MasterCard, and Discover cards are accepted. There are a limited number of slots for this camp. Slots are filled based on receipt of registration and deposit. CAMP PERFORMANCE The camp performance will take place at 3:00pm on the last day of camp. Friends and family are welcome. Location of the performance will be given during the first day of camp. CANCELLATIONS AND REFUNDS A written statement must accompany cancellation. Any refund may take up to 30 days from receipt of the written cancellation notice. Camp fees are not discounted when campers arrive late or leave early except for withdrawal due to illness or accident. In case of dismissal from camp, THERE WILL BE NO REFUND. The deposit of an applicant on the waiting list is processed only when a space becomes available in camp. CONFIRMATION OF APPLICATION Within two weeks each camper will receive an acknowledgment his/her application has been received. If you do not receive confirmation within two weeks, please contact The Lost Colony office. Applications are accepted in the order they are received. Should your application be received after capacity is reached, you will be notified via postcard or that your child s name has been placed on the waiting list. ARRIVAL AND DEPARTURE Campers should arrive between 8:45 AM and 9:00 AM. Campers should be picked up between 3:00 PM and 3:15 PM. Campers must be picked up by 3:20 PM. WHAT TO BRING: All articles should be marked with the camper s name Bug Repellent A bag lunch Sunscreen Comfortable Clothes Closed Toe Shoes Please do not send cell phones to camp. *Camp staff cannot be responsible for campers clothing or equipment. Campers should not bring jewelry, money, or non-essential articles of value. Radios, TV s, and cell phones are not permitted. For additional information or questions, please contact The Lost Colony business office. PAGE 5 of 5
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