Registration Form: 2016 Summer Drama Camp

Please choose the week your child will be attending.
1st Child - Full Name: *
1st Child - Full Name:
1st Child - Birthdate: *
1st Child - Birthdate:
My 1st Child identifies their gender as:
2nd Child - Full Name:
2nd Child - Full Name:
2nd Child - Birthdate:
2nd Child - Birthdate:
My 2nd Child identifies their gender as:
1st Parent/Guardian Name: *
1st Parent/Guardian Name:
2nd Parent/Guardian Name:
2nd Parent/Guardian Name:
Street Address: *
Street Address:
Home Phone: *
Home Phone:
Work/Mobile Phone:
Work/Mobile Phone:
Early Drop-off / Late Pick-up *
Please indicate the full name(s) of person(s) you would like to give permission to drop-off and pick-up your child. Please also indicate their relationship to your child (i.e. grandmother).
Emergency Contact Phone: *
Emergency Contact Phone:
I am the parent or legal guardian of the child/children (“Student”) registered for the green light arts Summer Drama Camp (“Camp”). I acknowledge that the Student is under 18 years of age, and desire that they participate in all the drama programming and related activities (“Programming”) conducted by green light arts (“Theatre”). In consideration of the acceptance of the Student’s attendance at the Camp, I fully discharge and release the Theatre, including its directors, instructors, staff and representatives assisting with the Camp, from any claims for damages or injury of any nature whatsoever suffered by the Student as a result of their attendance and participation in the camp and its Programming. In the event the Student is not physically fit to fully participate in the Programming I will advise the Theatre’s Artistic Producer in writing prior to the commencement of the Camp. I understand there may be Students attending the Camp who may suffer from severe food allergies and related conditions; therefore I agree that all snacks and lunches I provide and send to the Camp with the Student will be free of nuts or nut products. If a situation arises whereby the Student needs medical attention beyond any first aid provided by the Theatre, I agree to reimburse or pay directly for any incurred expenses. I am aware that staff are prohibited from giving prescription or over the counter medication to Students. If any activity carried out by the Student results in a suit, action or prosecution I agree to indemnify the Theatre, its directors, instructors, staff and representatives assisting with this Camp and save them harmless from and with respect to all suits, actions and prosecution, whether the activity occurred on or off the property where the Camp takes place. The Theatre has my permission to photograph, film and/or audio record of the Student during the Camp and final performance for promotional and archival purposes only. I consent to the use of the likeness of the Student in connection with the Theatre’s promotional and/or archival purposes throughout the world without any compensation and release the Theatre, its directors, instructors, staff and representatives assisting with this Camp from all claims for invasion of privacy, defamation, infringement of copyright or any other cause of action that may arise out of such use.
Name of Parent or Legal Guardian: *
Name of Parent or Legal Guardian:
Today's Date: *
Today's Date:


  • Participants must be between 9-14 years of age.
  • If you are registering more than 2 children, please fill-out a second registration form.
  • Registration is considered complete once we have received the following:
    1. Completed On-line Registration Form
    2. PAYMENT
  • Payment Options:
    • Personal cheque (payable to 'green light arts')
      • $250.00 plus HST = $282.50 total
      • Please mail cheque to: green light arts, 53 Betzner Avenue N, Kitchener, Ontario N2H 3B8
    • E-money transfer (please send to our Managing Director:
    • On-line using VISA, MasterCard or Amex:
      • $250.00 + HST + processing fees (Please use PAYMENT button on left-side menu. Processing fees may apply)
        • PLEASE NOTE: If you wish to AVOID extra charges like processing fees, please pay by personal cheque or e-money transfer!
  • Camp programming runs from Monday-Friday, 9:00am-4:00pm.
  • Regular drop-off time is 8:45am-9:00am (please arrive on time)
  • Regular pick-up time is 4:00pm-4:15pm
  • Early pick-up/late drop-off is available and can be added to the registration fee ($20/week for early drop-off, $28/week for late pick-up, $48/week for both early drop-off and late pick-up).
  • Add-ons (please include extended care costs in your payment, if applicable):
    • Regular registration = $250.00 plus HST ($282.50 total)
    • Registration PLUS $20 early drop-off (8-8:45am) = $270.00 plus HST ($305.10 total)
    • Registration PLUS $28 late pick-up (4:15-5:30pm) = $278.00 plus HST ($314.14 total)
    • Registration PLUS both early drop-off and late pick-up ($48) = $298.00 plus HST ($336.74 total)
  • Enrolment is limited so please ensure prompt delivery of all registration items in order to secure your child’s spot in the camp.
  • No refunds will be granted after July 8, 2016.
  • Questions and inquiries: Matt White, Artistic Producer:

Code of Conduct

Dear Parents/Guardians:

Your child’s safety and well-being are very important to us. In order to ensure the best camp experience for your child please note the following practices adhered to by all staff and representatives of green light arts:

  1. green light arts staff do not have specialized medical training. However, a number of our staff are certified in Basic First Aid and CPR-C. If your child has a specific medical concern, please consult with green light arts prior to your child’s enrolment to ensure that proper attention to their specific needs are in place.
  2. In case of emergency, sickness, accident or incident, parents/guardians must leave adequate contact information where they may be reached and be available to come and pick up/meet their child if needed.
  3. Participants enrolled in the camp are to be picked-up by authorized persons ONLY according to the written permission that parents/guardians supply to green light arts in the application form. Written notice is required for all changes to persons designated in this regard. Please note that photo ID may be requested from any adult (parent/guardian/or otherwise) who is picking up a child to verify their identity.
  4. green light arts demands the highest level of conduct from their staff and representatives. It is important to us that each participant feel supported, encouraged and respected. Our staff are hand-picked with the highest of standards for both their knowledge of theatre craft and their ability to interact well with youth of all abilities and backgrounds.
  5. In alignment with our mission/mandate statements and company goals, green light arts expects the highest level of conduct from its participants as outlined by the following:
            - Respect & Equality for All (regardless of race, gender, religion, beliefs or ability)
            - Courtesy in all Actions and Good Behaviour
            - Respect for Personal Property
            - Co-operation with green light arts Staff
  6. Participants are not to wander on or off the premises, either on their own or with other participants, without the supervision of a green light arts staff member. If a participant must leave a camp activity they are to stay under the supervision of a staff member until they return to the activity or until their parent or guardian can pick them up.
  7. green light arts will not tolerate hurtful, destructive or dangerous behaviour and reserves the right to remove participants from the camp without refund for violating the Code of Conduct.
  8. No refund will be issued to participants who withdraw with or without notice after July 8, 2016.

A special note about all things electronic…

green light arts acknowledges that we are all inextricably entwined with technology nowadays but ask that participants please leave electronic devices (iPods, laptops, iPads, smart phones, cell phones, gaming systems, personal robots and virtual realities) at home. Participants who are compelled to bring their mobile phones MUST be respectful during camp activities and keep them OFF during sessions. Participants are free to access their mobile phones during the breaks scheduled throughout each day.