Jr. Counselor Application Form

PAW JR. COUNSELOR APPLICATION 2022

First Name

Last Name

First Name

Last Name

EMERGENCY CONTACT INFORMATION

*Emergency Contact is an adult (other than the parent/guardian) who can be called in the event of an emergency, when a parent/guardian cannot be reached. PAW will always FIRST attempt to reach the parent/guardian.   Do not list parent/guardian here.

STUDENT PICK-UP AUTHORIZATIONS

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

Click Here For: Pickup Authorization Note
 

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

Click Here For: Walk/Bike Authorization Note

BUILD YOUR SUMMER SCHEDULE

GET A PAW T-SHIRT 🙂

Order it now with registration for only $15. (Available at camp for $20)

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)

CHOOSE YOUR CAMP DISCOUNT
BILLING INFORMATION
Payment Method (Please Select One):

To Authorize, Initial Here

Street

City

Zip

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

16-Digit Card Number

Expiration Date (mm/yy)

CV2# (Security Code)

CAMP POLICIES

To Agree, Initial Here

To Agree, Initial Here

To Agree, Initial Here

To Agree, Initial Here

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