Registration Form – Midlands Repertory Theater


Summer Camp:  June 17 – 21, 2019 @ 9am-5pm
Showcase:  June 22, 2019 @ 12 Noon
Location:  1110 Mason Rd., Columbia, SC 29203


Click here to read the Summer Camp Handbook.  Parents/Guardians of each participant must print, sign these forms and bring them to the mandatory orientation on June 21 at 5:00 p.m.

Please fill out the registration form below to register your child for the Midlands Repertory Theater program.  Please read the following paragraphs carefully because you will need to answer Yes or No for consent on the registration form.



I understand that I will be notified in the case of a medical emergency involving my child. In the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I understand that the Midland’s Repertory Theater Summer Camp will not be responsible for the medical expenses incurred, but that such expenses will be my responsibility as parent/guardian.



I hereby give permission for my child to be photographed during the Midland’s Repertory Theater Summer Camp. I understand the photos will be used to keep a journal of activities, to share during power point presentations and/or reports to our donors and for promotional purposes including flyers, brochures, newspaper and on the internet.  I understand that although my child’s photograph may be used for advertising, his or her identity will not be disclosed, I do not expect compensation and that all photos are the property of Midland’s Repertory Theater and its affiliates.