Child's Name *

First Name

Last Name

Parent/Guardian's Name *

First Name

Last Name

Parent/Guardian's Phone *

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Would you like to be added to the Columbia Theatre's eClub? We only send you information about upcoming events and happenings for the Columbia AND your email is safe with us! We never give out our patron's information for any reason! *

Yes! Sign me up!

No thank you, I would like to opt out.

PHOTO RELEASE *

The Columbia has my permission to use photos of my child taken during camp for publicity/development purposes. I understand that the images may be used in Columbia Theatre publications presentations, website, and social media.

Yes

No

Parent/Guardian's Name

I agree to the photo release.

First Name

Last Name