Camper's Name *

First Name

Last Name

Male/Female *

Male

Female

Prefer not to answer

Camper's Birthdate *

MM

DD

YYYY

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Contact Name *

First Name

Last Name

Primary Contact Phone *

(###)

###

####

Text Messages? *

Is it okay for Rich Theatre to send texts to the number above for time-sensitive updates?

Yes, texts are fine at this number.

No texts, please.

Secondary Contact Name

First Name

Last Name

Should We Include Secondary Contact in All Email Communications?

Yes, please send all emails to the secondary address as well.

No, please just use secondary address if the primary one fails.

Secondary Contact Phone

(###)

###

####

Emergency Contact Phone *

Again, this should be a number OTHER THAN that of the Primary Contact.

(###)

###

####