Spring Break Film Camp 2019

Camp Location/Performances: Calvary Baptist Church (4832 Haygood Road, Virginia Beach, VA 23455)

Camp Dates/Time: April 13 - April 18, 8:00am to 4:00pm (adjusted afternoon hours on Sunday 14th, tba)
Special Screening for Friends & Family on Monday, April 22 from 6:00pm - 8:00pm

* Please fill out one of these forms for each camper you are registering. *

CAMPER REGISTRATION

Camper's Name *
Camper's Name
Male/Female *
Camper's Birthdate *
Camper's Birthdate
(Areas of interest, special requests, concerns, etc.)
Mailing Address *
Mailing Address
Primary Contact Name *
Primary Contact Name
(Mother/father, guardian, grandparent, etc.)
Primary Contact Phone *
Primary Contact Phone
Text Messages? *
Is it okay for Rich Theatre to send texts to the number above for time-sensitive updates?
Secondary Contact Name
Secondary Contact Name
(Mother/father, guardian, grandparent, etc.)
Should We Include Secondary Contact in All Email Communications?
Secondary Contact Phone
Secondary Contact Phone
This could be the same as the Secondary Contact above, but not the Primary. This is who we would call during an emergency in the event that the Primary Contact is unavailable.
Emergency Contact Phone *
Emergency Contact Phone
Again, this should be a number OTHER THAN that of the Primary Contact.