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NOHA SUMMER CAMP APPLICATION Camp runs July 24-29 and July 31- August 4 at the NMHS Gym, from 10am – 4pm. Campers must bring their own lunch, a snack and water. On Friday, we will hold two performances, at 2:30pm and 5:30pm. Tickets will be available online and at the door. Tickets for the shows will be $5 per person/$2.50 for children under 12 (group fees available.) Costs for two weeks of camp are $100 per camper, and covers our costs to put on the shows. (Limited scholarships available – please see bottom of form and check box to receive more information.) PLEASE RETURN THIS FORM BY JULY 21! Forms can be printed, scanned and emailed to [email protected] OR Mailed via USPS to PO Box 351, Newport, NH 03773 CAMPER NAME: ___________________________________________________________________________________ (Last) (First) AGE________________________________ SCHOOL/GRADE: _____________________________________ MAILING ADDRESS: ______________________________________________________________________ (Street/PO Box) _______________________________________________________________________________ (Town) (State) (Zip) PARENT/GUARDIAN NAMES: ___________________________________________________________________ PLEASE INDICATE CONTACT INFORMATION FOR PARENTS/GUARDIANS BELOW AND IDENTIFY WHICH GUARDIAN CAN BE REACHED BY WHICH PHONE/EMAIL. PHONE NUMBER(S): (HOME) ____________________________________(CELL) ______________________________________________________________ (OTHER NUMBERS) _____________________________________________________________________________________________ (E-MAIL(S)) ______________________________________________________________________________________________________
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NOHA SUMMER CAMP APPLICATION - Newport Opera Housenewportoperahouse.com/wp-content/uploads/NOHA-SUMMER-CAMP-APPLICATION.pdfNOHA SUMMER CAMP APPLICATION Camp runs July 24-29 and July

Mar 18, 2020

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Page 1: NOHA SUMMER CAMP APPLICATION - Newport Opera Housenewportoperahouse.com/wp-content/uploads/NOHA-SUMMER-CAMP-APPLICATION.pdfNOHA SUMMER CAMP APPLICATION Camp runs July 24-29 and July

NOHA SUMMER CAMP

APPLICATION

Camp runs July 24-29 and July 31- August 4 at the NMHS Gym, from 10am – 4pm. Campers must bring their own lunch, a snack and water. On Friday, we will hold two performances, at 2:30pm and 5:30pm. Tickets will be available online and at the door. Tickets for the shows will be $5 per person/$2.50 for children under 12 (group fees available.) Costs for two weeks of camp are $100 per camper, and covers our costs to put on the shows. (Limited scholarships available – please see bottom of form and check box to receive more information.)

PLEASE RETURN THIS FORM BY JULY 21!

Forms can be printed, scanned and emailed to [email protected] OR

Mailed via USPS to PO Box 351, Newport, NH 03773

CAMPERNAME:___________________________________________________________________________________ (Last) (First)AGE________________________________SCHOOL/GRADE:_____________________________________

MAILINGADDRESS:______________________________________________________________________ (Street/POBox)

_______________________________________________________________________________ (Town) (State) (Zip)PARENT/GUARDIANNAMES:___________________________________________________________________

PLEASE INDICATE CONTACT INFORMATION FOR PARENTS/GUARDIANS BELOW AND IDENTIFYWHICHGUARDIANCANBEREACHEDBYWHICHPHONE/EMAIL.PHONENUMBER(S):(HOME)____________________________________(CELL)______________________________________________________________(OTHERNUMBERS)_____________________________________________________________________________________________(E-MAIL(S))______________________________________________________________________________________________________

Page 2: NOHA SUMMER CAMP APPLICATION - Newport Opera Housenewportoperahouse.com/wp-content/uploads/NOHA-SUMMER-CAMP-APPLICATION.pdfNOHA SUMMER CAMP APPLICATION Camp runs July 24-29 and July

THEATRICALEXPERIENCE(Notnecessarytoattendcamp.)Role Where Year_______________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ ________________________________________ ___________________________________________ _______________________________________ ___________________________________________ _______________________________________ ____________ Otherrelevantexperienceorspecialskills(Dance,gymnastics,voice,piano,etc.)_________________________________________________________________________________________________________________________________________________________________________________________________________________________MEDICALISSUESWESHOULDKNOWABOUT?(EG,ALLERGIES,ETC.)___________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ANYTHINGELSEWESHOULDKNOW?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________ WAIVER OF PARTICIPATION: I/we assume all risks and hazards incidental to be conducted to the program. I/we do further hereby release, absolve, indemnity and hold harmless The Newport Opera House Association, its Board of Directors, Employees, and Volunteers; The Newport School Board, the Newport School District and its Employees. In the event of an emergency requiring medical attention, I hereby grant permission to a physician or hospital personnel designated by the Newport Recreation staff to attend to my child. I expect notification before hospitalization. Parent/Guardian Signature_______________________________________________ Date________________________ PAYMENT:Paymentisdueonor/beforethefistdayofcamp,July24.CheckscanbemadeouttoNOHAandmailedto:POBOX351,Newport,NH03773.Creditcardpayments:NameonCard:_______________________________________________________________________________________________CardNumber:_________________________________________CID:_________________BillingZipCode:_____________LIMITED SCHOLARSHIPS AND/OR LUNCHES ARE AVAILABLE. PLEASE CHECK HERE IF YOU’D LIKE TO LEARN MORE _______Anyotherquestions?Callusat863-2412,[email protected].