Quest Theatre

QUEST THEATRE – 2011/12 Summer Drama Camp
REGISTRATION FORM

Please provide the following information for our survey

* First name:
* Last name:
* E-Mail:
* Address 1:
* City:
* Province/State:
* Postal/Zip code:
* Phone number:		(xxx) xxx-xxxx
Cell Number:		(xxx) xxx-xxxx
Participant Age:
* Participant Birthdate:

How did you hear about us? (input required) Please check ALL that apply.

Brochure mailed to my home

Calgary's Child Summer Camp Edition

Past Participant

Brochure in the Theatre Calgary Lobby

Friend

Brochure in Alberta Theatre Projects Lobby

Google Search

Brochure emailed to Me

Facebook AD

Poster at a Children's Store

Mom's the Word Program AD

Summer Camp Website Referral

Overpass Banner

The Company I work for

Poster at School

Poster at the Calgary Public Library

Road Sign in my Neighborhood

Calgary's Child Online Banner AD

Goggle Search - Sponsored AD link on the right hand side of browser

Other (If other please list in the box below)

Calgary Herald Summer Camp Guide

	Please describe how you heard about our program if not listed in the choices above.

	Parent/Guardian Name (First and Last)

	Participant's Name (First and Last)

Gender of Participant

Male

Female

	Any medical or behavioural conditions the instructor should know about?

Is your child registering with another camper and they would like to be kept in the same group at camp?

Yes

	If yes, what is the other camper's name?

	Which camp would you like to register for? (Please contact the office 403-264- 8575 for multiple registrations to ensure the discount is given.)

	Camp Fee

	A Pizza lunch is offered every Friday at a cost of $6 per person per day. Please indicate whether your child will partake in pizza lunch

Pizza Choice

	Camp hours are from 9am-4pm with drop-off between 8:30-9:00 and pick-up between 4:00-4:30. We do offer before and after care from 8:00-8:30 and from 4:30-5:00 daily. The cost for this service is $5 per 1/2 hour. Please indicate whether you will require additional care for your child on any or all days of the camp.

	I would like to make a Tax deductable donation in support of Quest Theatre. Charitable #11907 2163 RR0001.

	Donation Amount:

	Select a payment method (to pay by cash or cheque, submit your survey and then do not proceed to check-out. Instead please contact the office at 403-264-8575 ext. 21)

CANCELLATION POLICY: Cancellation is permitted (less a $50.00 administration fee) provided notice is given no less than 7 days prior to the first day of class. No refund will be given with less than seven days notice unless a doctor's note is provided.

I have been advised that the camp location is a multi-user venue and therefore the camp is NOT a NUT FREE camp.

	I have read and understand Quest Theatre's cancellation policy as listed above and agree to the terms. (insert your name in the field below.)

I have read and understand Quest Theatre's cancellation policy as listed above and agree to the terms.

I Agree

	Todays date is:

Please provide the best number(s) to reach you at to confirm this registration.

Camp Location: Camp is held at 900 - 47th Avenue S.W. (subject to change)

Please note: Registration in a camp is guaranteed ONLY when payment is received in full. Minimum Enrollment: We reserve the right to cancel camps due to insufficient enrollment. In the event of a cancellation by Quest Theatre, full refunds will be provided. Quest Theatre Society Charitable # 11907 2163 RR 0001.

I want to receive future information from Quest Theatre including news and special promotions. (please note - you can be removed from future correspondence at any time by changing your contact preferences).

Yes