2008 TASC APPLICATION
Circle Preference: Session One or
Session Two
Name of camper
________________________________________________________________
Street Address
_________________________________________________________________
City/State/Zip
___________________________________________________________________
Phone ( )___________________Email
___________________________________________
Age _________ Birth date with year
_________________Please circle: Male or Female
Grade in school (Fall 2008)
________________
Parent name (s)
_______________________________________________________________
Parent contact phone (Day)
_________________________ (Eve) ________________________
Emergency Contact: Name
______________________________ Phone ( )_______________
For the camper to complete: I am
interested in attending
Theatre Arts Summer Camp
because.......____________________________________________________________________
______________________________________________________________________________
Payment may be made by check only
to Little Lake Theatre. One TASC t-shirt is included in every enrollment
payment.
____ I have enclosed a check for
$195.00. This represents payment in full for Session _____.
____ I have enclosed a deposit of
$20.00 which will be credited to my enrollment fee. I understand my
deposit is non-refundable unless space is filled when Little Lake
receives this application. I also understand that the full fee for camp
is $195.00 and that Little Lake must receive the remaining payment in
full by the completion of the orientation meeting.
____ I have enclosed other:
____________________________________________
I WOULD LIKE TO ORDER MY T-SHIRT
IN ADULT SIZE: small medium
large x-large xx-large
Parent name (please print)
_____________________________________________
Parent’s signature
____________________________________________________
Mail to: TASC Little
Lake Theatre 500 Lakeside Dr. South Canonsburg, Pa. 15317
