REGISTER- Summer Acting Camp Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.123456I give permission for Bottle Tree Productions to use and publish my/my child's image (still, video, or other) for promotional purposes without compensation. This consent is given in perpetuity. I understand that names will not be used without permission. I understand that publication of photographs online makes them available for download world-wide, and I indemnify and hold harmless Bottle Tree Productions and its representatives from any claims arising from the use of these photos. We cannot accept your child into camp without this permission. If you do not give permission, please do not submit this form. Close the tab or brow (copy) *I give my consent and am legally permitted to do so.This permission is required for all registrations.I understand that payment in full must accompany this registration form in order to hold my child's place in camp. *I understand and agree to either remit payment by credit card or Etrans when I submit this registration.This permission is required for all registrations.I understand that refunds are not available after May 1, 2025, and that a $50 ($44.25 +hst) administrative fee applies to refunds. *I understand and agree to this refund policy.This permission is required for all registrations.NextContact Information For ease of use – you can enter your own information only one time, and include multiple children in your family on this form. In case of emergency, our first contact will be the Primary caregiver, then the Additional Contact, then the Emergency Contact. Only fields with a red asterisk are required. fee Tree indicate Name of Primary Caregiver *FirstLastPhone *Email *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryIf you have other email addresses that you would like Camp information sent to (another caregiver who would like to be kept up to date, please add them below.) Email #2Email #3Additional Contact NameFirstLastAdditional Contact PhoneEmergency Contact *FirstLastEmergency Contact Phone *NextActor Information How many children are you registering for camp? *Just oneTwoThreeChildren do not need to be attending the same dates, this is for ease of use for you. Name *FirstLastDate of Birth *School Grade in September *Is there anything we need to know about this actor to make their experience at camp successful? Any medical or other concerns? If there is nothing, please indicate 'no' . *How will you be paying? Save 10% on second and 15% on subsequent camps of the same or lesser value. (Issued as partial refund within 72 hours of payment) *includes siblingsEtransfer today to a.mortensen@bottletreeinc.comCredit card (4% credit card fee is added)Which camp(s) will this actor attend? (fee includes $45.00 admin fee + hst) *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $260.00July 7-18 “Surely, Sherlock!” for ages 9-14 – $638.00July 21-Aug 1 “Muggle Madness” for ages 9-14 – $638.00July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $575.00Which camp(s) will this actor attend? (fee includes $45.00 admin fee + hst and 4% cc fee) *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $270.40July 7-18 “Surely, Sherlock!” for ages 9-14 – $663.52July 21-Aug 1 “Muggle Madness” for ages 9-14 – $663.52July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $598.00NextActor #2 Name *FirstLastActor #2 Date of Birth *Actor #2 School Grade in September *(Actor #2) Is there anything we need to know about this actor to make their experience at camp successful? Any medical or other concerns? If there is nothing, please indicate 'no'. *Which camp(s) will Actor#2 attend? *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $260.00July 7-18 “Surely, Sherlock!” for ages 9-14 – $638.00July 21-Aug 1 “Muggle Madness” for ages 9-14 – $638.00July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $575.00Which camp(s) will Actor #2 attend? (fee includes $45.00 admin fee + hst and 4% cc fee) *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $270.40July 7-18 “Surely, Sherlock!” for ages 9-14 – $663.52July 21-Aug 1 “Muggle Madness” for ages 9-14 – $663.52July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $598.00NextActor #3 Name *FirstLastActor #3 Date of Birth *Actor #3 School Grade in September *(Actor #3) Is there anything we need to know about this actor to make their experience at camp successful? Any medical or other concerns? If there is nothing, please indicate 'no'. *Which camp(s) will Actor#3 attend? *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $256.00July 7-18 “Surely, Sherlock!” for ages 9-14 – $638.00July 21-Aug 1 “Muggle Madness” for ages 9-14 – $638.00July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $575.00Which camp(s) will Actor #3 attend? (fee includes $45.00 admin fee + hst and 4% cc fee) *June 30-July 4 (four days) “Breaking Bread” for ages 6-8 – $270.40July 7-18 “Surely, Sherlock!” for ages 9-14 – $663.52July 21-Aug 1 “Muggle Madness” for ages 9-14 – $663.52July 21-Aug 1 (nine days) “Viking Victory” for ages 9-14 – $598.00NextTotal *$0.00You have chosen to pay by Etransfer today. Please send to a.mortensen@bottletreeinc.com within 24 hours to hold space in camp. Thank you. Square *CardName on CardIf you are receiving a discount for multiple camps: Your discount will be refunded to your payment type within 72 hours of payment. Submit to Complete Registration