THEATRE Summer PROGRAMS. Lunch included! Information & Registration Booklet
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1 2016 Summer THEATRE PROGRAMS Fun, instructional theatre arts programs for children & young adults in grades 1-12 Lunch included! IP12-03 Rev:Mar15 Information & Registration Booklet
2 PROGRAMS & SCHEDULES The Theatre Bug Entering Grades: Duration:...8 days Dates:...July 5 8 & Time:...9am 1pm Lights! Stage! Action! Entering Grades: Duration:... 8 days Dates:...A: July 5 8 & B: July & Time:... 9am 3pm Spotlight on Musical Theatre Entering Grades: Duration:... 8 days Dates:.July & Time:... 9am 3pm PARENT INFORMATION Thank you for your interest in our Summer Theatre programs! Before any student can participate in the program, the following forms must be filled out completely & returned with the program fee. Required Forms: ü Enrollment Form ü Permission Form ü Risk & Release Form Program Fees: The Theatre Bug...$179 Lights! Stage! Action!...$229 Spotlight on Musical Theatre...$229 STUDENT INFORMATION Bring these with you: DO NOT WEAR: A book bag or backpack Pens, pencils & markers Sunscreen or protective clothing Sandals, flip-flips or open style shoes If you have a disability & may require accommodations in order to participate fully in program activities, please contact the director of the program to discuss your specific needs. AA/EEO Institution IP Rev:Feb16
3 21 st Annual Theatre bug Entering Grades: Duration:...8 days Space:...30 student limit Dates:... July 5 8 & Time:...9am 1pm (Students should arrive at the Fine Arts Center by 9am & be picked up promptly at 1pm) Cost:... $179 Performance Date:...Thursday, July 14 at 6:30pm The Theatre Bug program is a two-week introduction to the wonderful world of theatre for the very young student. The program combines theatre games, pantomime, music, dance & creative play. Through storytelling, expressive movement & improvisation, students discover the joy of being bitten by the theatre bug. Supervised recreation & a t-shirt are included. A performance for family & friends highlights the final evening. Lunch included! Sample daily schedule: 9:00 9:15...Group activities 9:15 10:00...Drama class 10:00 10:45... Music class 10:45 11:30...Recreation & games 11:30 12:00... Lunch 12:00 1:00...Rehearsal time
4 31 st Annual Lights! Stage! Action! Entering Grades: Duration:...8 days Space:...60 student limit Dates:... Session A: July 5 8 & Session B: July & Time:...9am 3pm (Students should arrive at the Fine Arts Center by 9am & be picked up promptly at 3pm) Cost:... $229 Performance Date:...Session A: Thursday, July 14 at 7:30pm Session B: Thursday, July 28 at 6:30pm We will take a script from page to stage in just 2 weeks! Classes will be held in the morning & will include acting, music, dance & more. In the afternoon we will rehearse & learn the thrill of putting on a play. Supervised recreation & a t-shirt are included. A performance for family & friends highlights the final evening. Lunch included! Sample daily schedule: 9:00 9:15... Meeting 9:15 10:00... Drama 10:00 10:45... Music 10:45 11:30...Recreation 11:30 12:00... Lunch 12:00 12:45...Dance 12:45 1:30... Drama 1:30 3:00...Rehearsal time
5 18 th Annual spotlight on musical theatre Entering Grades: Duration:...8 days Space:...40 student limit Dates:... July & Time:...9am 3pm (Students should arrive at the Fine Arts Center by 9am & be picked up promptly at 3pm) Cost:... $229 Performance Date:...Thursday, July 28 at 7:30pm One of our most popular programs! Learn the basics of song & dance while experiencing the thrill of performing in musical numbers & scenes from Broadway shows. Students are exposed to what it takes to be a triple threat in the world of theatre. A complimentary t-shirt is included. A performance for family & friends highlights the final evening. Lunch included! Sample daily schedule: 9:00 9:15... Meeting 9:15 10:15... Drama 10:15 11:15... Music 11:15 11:30...Break 11:30 12:30...Dance 12:30 1:00... Lunch 1:00 3:00...Rehearsal time
6 Register Today 2016 TheatrE programs One form per child additional forms can be downloaded from mwcc.edu/noncredit Name of Child First Last Grade (as of Sept. 2016) Student ID# Date of Birth Name of Parent/Guardian First Last Address Street City State Zip Home Phone Cell Emergency Contact Name Phone Number Relationship to Child If your child is enrolled in Lights! Stage! Action! & would like to be grouped with a friend, write his or her name here: Have you enrolled in MWCC programs in the past? Yes No One size t-shirts will be provided. Please enroll my child in: Theatre Bug... $179 Lights! Stage! Action! Session A... $229 Lights! Stage! Action! Session B... $229 Spotlight on Musical Theatre... $229 Continued >
7 Medical Information Medical Insurance Carrier Policyholder Name Policy # Doctor s Name Phone List any allergies Important Medical History to note: (e.g., asthma, bee stings, food allergies, etc.) It is of utmost importance that our office has a telephone number available where a responsible person can be contacted in case of accident or illness. Please list two (2) phone numbers below in the order that you would like contact made if we cannot reach you during the program or to release your child to if you cannot be reached. If your child has a disability & requires accommodations in order to participate fully in program activities, please contact the Division of Lifelong Learning at to discuss specific needs. Name Emergency Number Name Emergency Number Are there any legal restrictions on the release of your child or his/her records to a non-custodial parent? q Yes q No Pick-up Authorization: Is someone other than yourself authorized to pick up your child? q Yes q No Name Phone Payment: Cash In person Check Payable to: MWCC Credit Card or mwcc.edu/noncredit Mail registration form to: MWCC Lifelong Learning, RM 162, 444 Green St., Gardner, MA or noncredit@mwcc.mass.edu I hereby allow MWCC to photograph the child listed above for use in any type of media MWCC deems appropriate. This can include but is not limited to newspaper stories, printed literature & online information. I hereby give MWCC, its legal representatives & assigns, those for whom MWCC is acting, & those acting with its permissions, or its employees, the right & permission to copyright and/or use, reuse and/or publish, & republish photographic pictures. Check here to opt-out PERMISSION & ASSUMPTION OF RISK & RELEASE: I give my permission for the child listed above to participate in the selected program(s). I understand that in the unlikely event of an accident, every attempt will be made to contact the person(s) named below. If unsuccessful, I give my permission to the staff to secure emergency medical services to aid my child, including (if necessary) hospitalization. Any expense arising from the injury or illness is the responsibility of the person signing below. In consideration of being permitted to participate in this program, I, the undersigned, in full recognition & appreciation of the dangers & hazards inherent in such activities, which are described in this brochure, during my child s enrollment and/or participation in MWCC activities during this program, do hereby agree to assume all risks & responsibilities surrounding my participation in this program, or activities undertaken as an adjunct thereto; & I assume all risks for injuries & illness: caused by or related to this program: & further I do for myself, my heirs & personal representatives hereby defend hold, harmless, indemnify, & release, & forever discharge MWCC & all its officers, agents, & employees from & against all claims, demands, & actions, or causes of actions, on account of damage to personal property, or personal injury or death which may result from my participation, & which results from the causes beyond the control of, & without the fault or negligence of MWCC, its officers, agents or employees, during the period of participation. Parent/Guardian Signature: Date: Registration is not complete & your child(ren) cannot attend until the medical/permission form is submitted.
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