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NAME
_____________________________________________________
AGE _______
STREET ADDRESS
_____________________________________________________________
CITY_________________________________ STATE
_______ ZIP ___________
PHONE: DAY ________________ EVENING
______________________ CELL_______________________
_____KIDS ON STAGE-A SUMMER OF STARS: $1275.00
______KIDS ON STAGE JR: $595.00
_____TWEENS SPECIALTY CAMPS: Circle Choice(s):
Session 1_____
Session 2_____ Session 3: _____
Session 4____
Session 5: _____
_____TEEN SPECIALTY CAMPS: Circle Choice(s):
Session 1_____
Session 2_____ Session 3: _____
Session 4: _____ Session
5:_____
____________________I have
read the PAYMENT AND REFUND POLICIES and agree to them.
Signature of Parent or Guardian
METHOD OF PAYMENT:
Paid in full _____ $100.00
Deposit (Kids On Stage Camps) _____
$50.00 Deposit (Tween / Teen Specialty Camps) ______
Check / Money Order#
_______ Amount
$
(payable to NJ School of Dramatic Arts)
**Credit Card:
Visa # _______________________________________________________
Master
Card # _________________________________________________________
**Charge the above Credit Card :
$
Name on credit card ___________________________________
Expiration Date______________
Signature of card owner
___________________________________________________
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Mail
To: |
N.J.
School of Dramatic Arts 593 Bloomfield Ave.
Bloomfield, NJ 07003 |
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