2026 Jungle Book Camp Registration K-4

K-4th Summer Camp Intensive Jungle Book, Kids Registration Form

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Name(Required)

First Last

Grade Completed by June 2026(Required)

Age(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Student Cell Phone (if applicable)

Student Email (if applicable)

Parent/Guardian Name(s)(Required)

Work Phone

Cell Phone(Required)

Parent Contact Email *This Email will receive imporant updates from the production staff.(Required)

Additional Email Addresses

Emergency Contact Name/Phone(Required)

Single Registration(Required)

Price:

Add Additional Child

Yes, I would like to add an additional child.

Name

First Last

Grade Completed by June 2026

Age

Student Cell Phone (if applicable)

Student Email (if applicable)

Additional Child Registration

Price:

Add Additional Child

Yes, I would like to add an additional child.

Name

First Last

Grade Completed by June 2026

Age

Student Cell Phone (if applicable)

Student Email (if applicable)

Additional Child Registration

Price:

Add Additional Child

Yes, I would like to add an additional child.

Name

First Last

Grade Completed by June 2026

Age

Student Cell Phone (if applicable)

Student Email (if applicable)

Additional Child Registration

Price:

At Main Stage Inc, we are committed to creating a positive and supportive environment for all participants. We understand that children may face challenges, and we will work collaboratively with parents to support positive behavior. However, consistent behavioral issues that disrupt rehearsals or performances may result in progressive consequences, which can include verbal warnings, parent meetings, temporary suspensions, or in severe cases, removal from the production. By enrolling your child, you agree to support and uphold these expectations to ensure a respectful and productive experience for all involved. If a student is removed from a production due to behavior no refund will be given.

Acknowledgement(Required)

I acknowledge Main Stage Inc’s behavioral clause

WAIVER: I hereby give my permission for my child to take part in this program. I will not hold the instructors’, The Main Stage, Inc. or the Saint Mary’s College or Battell Community Center liable for injuries that may occur. I have adequate hospitalization insurance to cover such injuries. I further understand program dates may need to be canceled or rescheduled due to circumstances beyond The Main Stage, Inc. control.

Waiver for Photo and Video consent: I grant permission for the production team and The Main Stage Inc. to use my child’s photograph, video of rehearsal or performances and/or personal statements to publicize the activities of The Main Stage Inc. without compensation.

WAIVER: I understand The Main Stage, Inc. refund policy. My child’s participation is secure. However, should withdrawal be necessary, $100 of my payment is non-refundable as of today and the entire fee becomes non-refundable 2 weeks prior to the program start date.

Online Processing Fee

Price: $0.00

Total

Credit Card

Registration Accuracy

All answers are true and accurate to the best of my knowledge