OrangeMite's Summer Theatre camp is an educational program presented by the OrangeMite Shakespeare Company. The camp is open to students ages 9 to 15 (grades 4 through completed 8). The program seeks to support academic achievement, ignite passion and creativity, and enhance the self-esteem of the participants in the program through active engagement in the dramatic works of William Shakespeare. A breakdown of daily activities can be found here. Additional information can be found on the Summer Camp home page, other questions regarding the program can be made to the director, Megan Garbrick (mgarbrick@orangemite.org).

If you would prefer to complete the registration through pencil and paper, a form is available upon request. This form can be sent along with the tuition fee to OrangeMite Studios, P.O. Box 341, Dover, PA 17315. For questions regarding OrangeMite Policy, please review our policy manual.

Student Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Parent Email Address

Parent Phone Number

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Health Insurance Provider

Policy Number

Doctor's Name and Medical Practice

Does your child have any medical conditions that OrangeMite needs to be aware of while they participate in this program?

Is your child taking any medicine, pills, injections, or using an inhaler?

In regards to the previous question, if yes, what and how often?

Does your child have allergies to any foods, insects, etc.? If so, what?

EMERGENCY CONTACT 1

First Name

Last Name

EMERGENCY CONTACT 1 PHONE#

(###)

###

####

EMERGENCY CONTACT 2

First Name

Last Name

EMERGENCY CONTACT 2 PHONE#

(###)

###

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I plan to attend the informational meeting on July 3 at 7pm at Dover Community Park.

Returning participants do not have to attend the meeting. New students and the parents are encouraged to attend. If you are unavailable, the information can be emailed to you ahead of time.

YES

NO

UNSURE

Payment Method

Please choose how you will make the tuition payment of $125 for the 10 days of camp.

ONLINE via OMS Website - Preferred (see below)

CHECK - sent to P.O. Box 341, Dover PA 17315

*PLEASE CLICK THE SUBMIT BOX BEFORE MOVING ON TO PAY THE TUITION FEE.