Norwin Theatre Club

Summer Theatre Camp Registration Form

June 17-21 & June 25-28, 2013
Summer camp packages:
Please check one
Early Registration (postmarked by Friday, May 24, 2013)
_____Single Student Package - $200.00
_____Family Package, 2 siblings - $300.00
_____Family Package, 3 siblings - $400.00
General Registration (postmarked by Monday, June 10, 2013)
_____Single Student Package - $250.00
_____Family Package, 2 siblings - $350.00
_____Family Package, 3 siblings - $450.00

Mail this completed registration form with payment to:

Norwin High School
Attn: Lauren McCurdy
251 McMahon Drive
North Huntingdon, PA 15642
Please, checks only made payable to Norwin Activity Fund

Questions? Contact Lauren McCurdy

lmccurdy@norwinsd.org or at 724-861-3005 x1278

In the event that a Family Package is selected please include a separate Summer Theatre Camp Registration Form for
each student planning to attend.

Student information:
Name: ___________________________________________
Grade: ________
Birthdate: _______
School District:_________________________________
Cell Phone: ____________________________
Email: ______________________________________________
Address: ________________________________
_________________________________________
_________________________________________
Please list any allergies:
__________________________________________________________________________________________________
__________________________________________________________________________________________________

Parent information:
Name: ____________________________________________
Cell Phone: ____________________________
Email: ______________________________________________
Address: ________________________________
_________________________________________
_________________________________________

Emergency contact if parent is unavailable:

Name: _____________________________________________
Relationship to child:_________________________
Cell Phone: __________________________________