2013 Theatre Arts Camp Registration ONLINE

Monocacy Valley Church uses the same security as banks and the military (128 bit SSL encryption).  All personal, credit card, & bank information is submitted using 128 bit encryption. There is no stronger form of protection than this encryption.  Your information is held securely by MVC. This information will remain private and will never be given away to third parties, other than to process your payment.  Please know we go to great lengths in securing your information.  If you have ANY questions you can
contact us at 301.865.9100  Monday - Friday from 9am to 3pm


For details about the 2013 Theatre Arts Camp program please click here

Today's Date: 


Participant Name:  First:    Last:    MI: 

Date of Birth:     Grade Fall 2012:    Gender: 

Address:     Telephone:     Tee-Shirt Size:

Siblings attending this camp: 


Family/Parent Email: 


Name of Parent/Guardian 1: 


Home Phone:     Work/Cell: 

Name of Parent/Guardian 2: 


Home Phone:      Work/Cell:   


Additional Emergency Contact:     Relationship: 


Home Phone:    Work/Cell: 


MEDICAL INFORMATION

Please list participant's medical conditions or allergies:


Name of Primary Physician:    Phone: 

Is participant covered by personal/family medical insurance? 

If yes, name of insurer: 

Policy or group number: 

By clicking on "YES" below, I, the parent/guardian, acknowledge that all information above is correct and give approval for my child to participate in the Monocacy Valley Church Theatre Arts Camp on July 8-12, 2013.  I authorize Monocacy Valley Church staff to approve medical treatment, if unable to reach the parents/guardians listed above, in the event of a medical emergency.

       Yes, I accept


After clicking on "submit form" you will be redirected to our "online giving"
page where you can make payment online for the Theatre Arts Camp 2013


Enter the numbers as they
are shown in the image above