Jr. Counselor Application Form – Performing Arts Workshops

Student's Full Name*

First Name

Last Name

Home Address*

City*

State*

Zip Code*

Birthdate*

Age at Time of Camp*

Student's Gender*

Parent 1 Full Name*

First Name

Last Name

Parent 1 Cell/Home Phone*

Parent 1 Work/Day Phone

Parent 2 Full Name*

First Name

Last Name

Parent 2 Cell/Home Phone*

Parent 2 Work/Day Phone

Parent's Email Address*

Student's Cell Phone*

EMERGENCY CONTACT INFORMATION

*DO NOT list parent/guardian here. PAW will always FIRST attempt to reach parents/guardians in the event of an emergency. Your emergency contact MUST be an adult who serves as third party contact who can be called if the parents cannot be reached.

Emergency Contact Name*

Emergency Contact Phone*

Pediatrician Name*

Pediatrician Phone*

STUDENT PICK-UP AUTHORIZATIONS

Jr. Counselor will be picked up by:*

If other than Parent will pick up, complete and return the following form via email: performingartsla@aol.com.

Click Here For: Pickup Authorization Note

I give permission for my child to walk/bike home from camp daily:

If YES, complete and return the following form via email: performingartsla@aol.com.

Click Here For: Walk/Bike Authorization Note

BUILD YOUR SUMMER SCHEDULE

Session 1: June 15th - June 26th

Select Camp Location & Show

Session 2: June 29th - July 10th

Select Camp Location & Show

Session 3: July 13th - July 24th

Select Camp Location & Show

Session 4: July 27th - August 7th

Select Camp Location & Show

Week 7 (One-Week Adaptation): July 27th - July 31st

Select Camp Location & Show

PERFORMING ARTS EXPERIENCE & SCHOOL INFO

Describe your experience in the arts*

Describe why you would like to be a PAW Jr. Counselor*

List names of school/summer performing arts programs you have attended*

Name of your school*

Current grade level*

Number of years experience in the Arts*

Current grade point average*

GET A PAW T-SHIRT

Order it now with registration for only $20. (Available at camp for $25)

ORDER A PAW THEATERGRAM

A keepsake TheaterGram with your loving words and congratulations for an endeavor well done will be hand delivered to your Jr. Counselor by PAW teachers backstage before the show. Just $10

(A truly wonderful way to help support PAW’s scholarship program)

PAW TheaterGram

No

Yes

CHOOSE YOUR CAMP DISCOUNT

Only ONE discount, gift certificate, or coupon may be applied per registration. The amount will be deducted from your total when PAW manually processes your credit/debit card.*

Other PAW Discount or Coupon ID Number

BILLING INFORMATION

Cardholder’s Name (as it appears on the card)

Cardholder’s Phone Number

Cardholder’s Billing Address

Street

City

State

Zip

Credit/Debit Card Information

Type Of Card (VISA, MC, AMEX, etc.)

16-Digit Card Number

Expiration Date (mm/yy)

CV2# (Security Code)

CAMP POLICIES

1. I have read, understood and agree to all camp registration, hours, attendance, and refund policies..
2. I understand the Jr. Counselors must be 15 or 16 years old at time of their session. PAW reserves the right to offer up to 4 spaces per session, per camp site.
3. Allow PAW to use their selected nurse, physician or call 911 in the event of an emergency and I cannot be reached. I must disclose to PAW any special needs or allergies my child may have and agree to provide arrangements as required by PAW. Failure to do so may result in the termination of camp participation and/or removal from camp.
4. Allow my child to participate in any promotional pictures and videos from the camp.
5. Cancellation of any session has a $95.00 non-refundable registration fee.
6. Refund requests must be submitted in writing via email to performingartsla@aol.com. Deadline to submit a refund request is May 15, 2026. No refunds after May 15th.
7. I understand there are no cash refunds if my child is absent due to illness, withdraws early or is removed from camp due to behavior or discipline issues.
8. PAW reserves the right to substitute activities as necessary.
9. Space is limited - register early to ensure a spot. A child may join a session after it has begun if space is available. Parents can call the PAW office to confirm availability when signing up on or after the start date of a session or speak with the on-site camp director. PAW reserves the right to cancel a camp session if the enrollment is insufficient. In the event of a cancelled session due to low enrollment, PAW will refund in full or apply tuition to another session of my choosing.
10. I understand that Jr. Counselors need to arrive at camp each day between 8:00am and 8:30am and are asked to remain present until the camp day ends at 3:00pm. Unless ill, Jr. Counselors are asked to attend camp each day of the session(s) they are registered for.
11. I understand Jr. Counselors are not permitted to leave campus during camp hours to buy snacks/food/lunch and are required to BRING food each day including a snack for mid-morning break, a packed lunch, as well as a water bottle in order to stay hydrated.*

To Agree, Initial Here

I understand and agree to all of PAW’s COVID safety measures, protocols and policies stated herein. I additionally understand that the following protocols may be subject to change based on COVID case numbers at the time of each camp session. These include but are not limited to; providing an “optional” mask wearing policy with the understanding that it may return to a mask mandate if PAW deems it necessary, requiring frequent hand washing/hand sanitizing, requiring temperature checks for Jr. Counselors, campers or adults as needed, not allowing Jr. Counselors who display any potential symptoms of COVID on campus (runny nose, fever, cough, headaches, fatigue, etc.). I understand that Jr. Counselors may only return with proof of a fully Negative rapid COVID test (which can also be brought to camp and performed together). I understand that PAW offers an “optional” mask wearing policy for audience attendees with the understanding that PAW retains the right to require masks be worn if we deem it necessary, as well as limiting the number of family members that may attend any camp performance. I understand that some of these policies are prescribed by the CDC for public safety, some are required per each camp location rental and some of which we here at PAW require in order to ensure the safety of each Jr. Counselor, camper, staff member, teacher and family member.*

To Agree, Initial Here

In the event of an Act of God and/or Force Majeure event, I understand, acknowledge and agree to the following: Based on Performing Arts Workshops’ assessment of public health and safety, PAW reserves the right to switch to or from in-person and online programming platforms or to reschedule the PAW Workshops/Camps/Classes. If an Act of God and/or Force Majeure event occurs once a parent or guardian has paid and registered for any PAW Workshops/Camps/Classes, the full tuition credit (if prior to the start date) or prorated remaining tuition credit (if the session has already begun) will be applied to future PAW Workshops/Camps/Classes of the parent’s/guardian’s choosing and is valid for a period of three years from the time of the event. Unused tuition will be deemed to have been forfeited if not redeemed for PAW Workshops/Camps/Classes, in that three year period.*

To Agree, Initial Here

Click Here: Definitions of an act of God and force majeure.

On behalf of my child and for myself, I knowingly assume all risks arising from participation in activities related to camp programming. I certify that I have legal authority to sign this release/waiver of liability, and sign it without duress or coercion.*

To Agree, Initial Here