Theatre Camp Registration
Making memories that last a lifetime.

More About Our Program

DTW’s Summer Theatre Program includes: all classes in the session, participant’s show t-shirt, a rehearsal script, and a closing party. Our goal is to provide a superior experience to all young adults interested in theatre and the performing arts. All participants will perform in a full-stage production of the musical The Wizard of Oz. DTW’s Education Team consists of theatre education professionals who are trained in producing professional theatre and teaching theatrical arts. Program participants will spend a significant amount of time learning acting, singing and dancing for the musical and daily classes and special workshops in subjects like improv, stage combat, Shakespeare and more.

Tuition:
Registration is currently open at the discounted rate of $99 per week until June 1st, 2017. Registration after June 2nd, 2017 is $125 per week. The DTW’s Summer Theatre Program is available on a first come, first serve basis until sessions fill.

Financial Aid and Scholarships:

Financial Aid and discounts are available to those who qualify, including a limited number of scholarships for qualifying applicants. Desert Theatreworks offers a very competitively priced program compared with other summer camps in the Coachella Valley, and provide an exceptional experience. Please call (760)980-1455 and speak to a DTW Representative about any Financial aid or discounts your child may qualify for.

Summer Theatre Program Dates:
June 19, 2017 to July 20, 2017. Performances TBA

Hours:
9:00AM to 2:30PM (Monday-Thursday)
Performance week schedule and full itemized schedule to be handed out first day of program.

Extended Care:
8:00AM to 9:00AM and 2:30-3:30PM (additional fees apply)

Lunch/Snacks:
Students bring their lunch and any snacks or drinks that they would like to eat during break times. We will not have a refrigerator available, so please put the lunch into a cooler bag.

Program Location:

Indio Performing Arts Center
45175 Fargo St, Indio, CA 92201

Participant Information

First Name *

Last Name *

Birth Date *

Age *

School attending

If student is a minor, do parents live together? *

Yes

No

Household / Adult Primary Contact

Relationship to Participant: *

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Cell Phone

Work Phone

Email Address *

Household / Adult Secondary Contact

Relationship to Participant: *

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Cell Phone

Work Phone

Email Address *

Pick Up & Drop Off Authorization - List of Authorized Agents

First Name *

Last Name *

Relationship *

First Name

Last Name

Relationship

First Name

Last Name

Relationship

First Name

Last Name

Relationship

First Name

Last Name

Relationship

Emergency Contacts other than parent(s)

First Name *

Last Name *

Cell Phone *

Relationship

First Name

Last Name

Cell Phone

Relationship

First Name

Last Name

Cell Phone

Relationship

Students Medical Information

Any health problems, disabilities, or learning disabilities? Section (504) *

Yes - please explain below

No

Health problems, disabilities, or learning disabilities? Section (504)

Does the student have an Individualized Education Plan (IEP)? *

Yes - Please explain below

No

Individualized Education Plan (IEP)

Does your child take any medications? *

Yes - list below

No

List of Medications

Any allergies to food or other substances? *

Yes - list below

No

Allergies to food or other substances

Student's Physician & Insurance Information

Physician First Name *

Physician Last Name *

Physician Phone Number *

Hospital or Clinic *

Insurance Carrier *

Group Number *

ID Number *

Phone number *

Consent To Care

This agreement shall be construed to require Desert Theatreworks Corp. and its staff to exercise usual and customary care for child named above. *

Yes, I Consent

No, I Do Not Consent

Authorization of Consent to Care

(I), (We) the undersigned, do hereby authorize an instructor of Desert Theatreworks Corp. as agent(s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable, and is to be rendered under the general or special supervision of any physician and surgeon licensed under the provisions of the Medical Practice Act on the medical staff of any accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.

It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician in the exercise of his/her best judgment may deem advisable.

This authorization shall remain effective through December 31, 2017. *

Yes, I Consent

No, I Do Not Consent

Hold Harmless Agreement

The undersigned agrees to indemnify, and hold harmless Desert Theatreworks Corp., and all its assigns, employees, agents, individually and collectively from and against all costs, losses, claims, demands, suits, actions, payments, and judgments, including legal and attorney fees, arising from any and all personal or bodily injuries, property damage, or otherwise, however caused, brought or recovered against any of the above that may arise for any reason from this activity.

In case of emergency, I give the person in charge of Desert Theatreworks Corp. my permission to administer first aid or to obtain medical treatment for the child in emergencies. I agree to hold the City of Indio, any employee or volunteer of the City of Indio free from any liability if any problems, complications, or injuries arise from such treatment. Desert Theatreworks Corp. staff is authorized to use its best judgment to select appropriate medical treatment from physicians and hospitals designated by the parents.

Any doctor or hospital to which the child is taken to is hereby authorized to render any and all necessary emergency treatment. We will make all efforts to contact the parent first. The parents of the child named below agree to assume full responsibility for any expenses incurred with this emergency treatment. *

Yes, I Consent.

No, I Do Not Consent

How Did You Hear About DTW's Summer Camp?

*

Theatre Camp Registration Making memories that last a lifetime.

Participant Information

Household / Adult Primary Contact

Household / Adult Secondary Contact

Pick Up & Drop Off Authorization - List of Authorized Agents

Emergency Contacts other than parent(s)

Students Medical Information

Student's Physician & Insurance Information

Consent To Care

Authorization of Consent to Care

Hold Harmless Agreement

How Did You Hear About DTW's Summer Camp?

Theatre Camp Registration
Making memories that last a lifetime.