Westminster Conservatory 2014 Music Theater Camps
Fill out one Registration form per student.

NOTE: Items marked * are required.



Applicant Information
 * Last Name of Student:
 * First Name of Student:
 * Birth Date (month/day/year):
 * Grade as of Sept. 2014:
 * Age as of July 1, 2014:
 * Student is a: Returning Student    New Student   
If a new student, where did you hear about our summer camps?
 * Student is: Male    Female   
 * T-Shirt Size: Youth XS (2-4)  Youth S  Youth M  Youth L
Adult S  Adult M  Adult L  Adult XL
Registration Information
 * Check off the camps for which
the student is registering:
Broadway Stars (Morning Only) (Grades 1-2) (July 7-11)
Broadway Stars (Full Day) (Grades 1-2) (July 7-11)
Sing Your Heart Out (Morning Only) (Grades 3-5) (July 7-11)
Sing Your Heart Out (Full Day) (Grades 3-5) (July 7-11)
Middle School Musical Theater Intensive (Grades 6-8) (July 14-18)
High School Musical Theater Intensive (Grades 9-12) (August 4-15)
I would like Early Drop Off (For Broadway Stars and Sing Your Heart Out Only)
Yes No
 
Refer a Friend Progam (For Broadway Stars and Sing Your Heart Out only)
Did someone refer you to this camp as part of the 
"Refer a Friend Program"?:
Yes    No   
If yes, Name of referring friend:
Name of Parent or Guardian of referring friend:
I understand that under the "Refer a Friend Program", submission of the name of the referring friend will entitle them to a discount towards their camp tuition if I sign up for the same camp. I also understand that if two students sign up for the same camp, they cannot use the "Refer a Friend Program" to refer each other. Yes   
Contact Information
 * Student Home Address 1:
Student Home Address 2:
 * City:
 * State:
Province/Region: (If State is "Other")
 * Zip/Postal Code:
 * Country:
 * Home Phone of student (w/ area code): ()
Father/Guardian Name:
Father/Guardian Work Phone (w/ area code): ()
Father/Guardian Cell Phone (w/ area code): ()
Father/Guardian Email Address:
Mother/Guardian Name:
Mother/Guardian Work Phone (w/ area code): ()
Mother/Guardian Cell Phone (w/ area code): ()
Mother/Guardian Email Address:
 * Name of Emergency Contact:
 * Phone Number of Emergency Contact (w/ area code): ()
Billing Information
 * Send Bill To: Mr.    Mrs.    Ms.    Dr.   
 * Name:
 * E-mail Address:
 * Is Billing Address the same as Student Home Address listed above? Yes     No     (If "No", please specify below.)
Billing Address 1:
Billing Address 2:
City:
State:
Province/Region: (If not from US)
Zip/Postal Code:
Country:
Payment Information
* Please read the conditions of registration and  check the box indicating that you accept them. 
A non-refundable camp deposit of $100 must accompany this form. If registering after June 1, full payment must be made.

NOTE:
 Refunds, credits, or make-ups cannot be given for camp days missed by the student. Westminster Conservatory reserves the right to cancel a camp up to two weeks prior to the starting date due to insufficient enrollment. Families affected will receive a full refund.
  I understand and accept the conditions for registration / withdrawal as outlined in the Westminster Conservatory 2014 summer camp brochure. 
  Yes

* Select the appropriate option to indicate the amount you are including with your registration form: Non-refundable deposit of $100 (NOTE: This option is available only if registering by 6/1))
Payment in full for Broadway Stars or Sing Your Heart Out 1/2 day ($225 if registering by 5/15 or $245 after 5/15)
Payment in full for Broadway Stars or Sing Your Heart Out full day ($400 if registering by 5/15 or $425 after 5/15)
Payment in full for Middle School Musical Theater Intensive ($360 if registering by 5/15 or $380 after 5/15)
Payment in full for High School Musical Theater Intensive ($670 if registering by 5/15 or $690 after 5/15)

I am also including the $50 fee for early drop off (Broadway Stars and Sing Your Heart Out only) :
Yes


I am registering less than one week prior to tthe start of camp and am including the $50 late fee :
Yes

 
 * Total Payment Amount :  $
Daytime Phone (w/area code):   ()
 * Payment Information:  We accept Visa, MasterCard, Discover & American Express.
Card Type :
Credit Card Number:
Expiration Date (mmyyyy):
Security Code :
Name as it appears on card:
 * Is Credit Card Billing Address the same as Student Home Address listed above? Yes     No     (If "No", please specify below.)
Billing Address 1:
Billing Address 2:
City:
State:
Province/Region: (If not from US)
Zip/Postal Code:
Country:
Form Submission


Click Submit to send this form to Rider University. An acknowledgement screen will then appear.