Annie Jr 2026 registration form for Jessie Byun – Elefante Music & School for the Performing Arts

"*" indicates required fields

Camper's Name*

First Last

Parent/Guardian's Name*

First Last

Age*

Please select the age the camper will be in July, 2026

Grade*

Please select the grade that camper will be entering in 2026-2027 school year.

Camper's Date of Birth*

Month

Day

Year

Phone*

Email*

Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contacts

Emergency Contact #1 Name*

First Last

Relation to Camper*

Emergency Contact #1 Phone*

Emergency Contact #2 Name*

First Last

Relation to Camper*

Emergency Contact #2 Phone*

T-Shirt Size*

Allergy/Medical Disclosure

Does your child have an allergy that requires the use of an Epi Pen or a device designed for self-administered asthma treatment (not necessarily Epinephrine)?*

Yes

My child is allergic to:*

Check all that apply from the choices below*

An Epinephrine injector has been prescribed for my child.

A device designed for self-administered emergency treatment (not necessarily Epinephrine) has been prescribed for my child.

My child has one of the above-referenced devices and has received adequate training on how and when to use their device, and can use it properly in case of an emergency.

My child has one of the above-referenced devices but has not received adequate training on how and when to use their device, and can not use it properly in case of an emergency.

No device(s) similar to those mentioned above has been prescribed for my child.

Auto-Injector Staff Administration Consent*

I authorize staff to administer auto injector.

I authorize Elefante Music and School of Performing Arts staff and volunteers to administer an Epinephrine injector (Epi-Pen® or similar devices designed for self-administered asthma treatment) to my child if they appear to have had significant exposure and/or a severe allergic reaction to a specified allergen. I agree to release, indemnify, and hold harmless Elefante Music and School of Performing Arts and any of its staff, volunteers, or agents from lawsuit, claim, expense, demand, or action against them, including reasonable attorneys’ fees, suffered by any of the foregoing indemnities and arising out of a claim related directly or indirectly to administering or failing to administer the Epinephrine injector. I am aware that the injection will likely be administered by a staff member or volunteer who is not a healthcare professional.

Note: all children for whom an Epinephrine injector has been prescribed MUST bring the injector to camp with them every day. The injector must be in a plastic bag clearly-labeled with the child’s name.

Any medical, emotional, or special needs you would like us to be aware of:

Select Your Camp(s)

MTI (Base)

Annie Jr

Ages: 7–14

July 21–July 25
9:00am–3:00pm
Performances Friday August 7th at 7pm and Saturday, August 8th at 3pm and 6pm

There are no options available for this field.

Agreements

Consent to treat in the event of a medical emergency.*

If you cannot be reached in an emergency, do you give permission to the proper medical staff to hospitalize, secure proper treatment for, and order injection, anesthesia, or surgery for this child, understand the information on this form will be shared on a “need to know” basis with Elefante Music staff?

I agree to the medical emergency policy.

Elefante's nut-free policy agreement*

Campers will be bringing bagged lunches from home. In order to keep our lunch area safe for campers with serious food allergies, we request that all food brought into the facility be nut-free.

I agree to Elefante’s nut-free policy.

Code of Conduct & Core Values*

Elefante Music & School for the Performing Arts requires that all students comply with
our Code of Conduct. We reserve the right to remove from lessons, classes, camps, or
similar activities any student who does not comply with the Code of Conduct and/or
presents a substantial disruption to the delivery of instruction or to the educational
environment.
To comply with the Code of Conduct, all students will agree to:
— Create a safe space free from bullying, name-calling, or discrimination.
— Show respect for and maintain a positive attitude toward classmates
and instructor(s) at all times.
— Comport themselves according to instructor rules of safety, attention,
and behavior.
— Act with honesty and personal integrity.
— Refrain from handling items or equipment in the classroom, according
to instructor rules.
— Share ideas with others, accept the ideas of others, and work as a
team.
— Use appropriate language.
— Refrain from any form of verbal and/or physical altercations.
— Respect the personal space and physical boundaries of others.
— Meet attendance and punctuality expectations.
— Refrain from use of electronic devices during class time.
— Refrain from any social media/posting of classmates or class activities.
— Fully disallow any illegal substances such as alcohol or narcotics.

I have read and agree that my child will comply with Elefante Music’s Code of Conduct and Core Values.

Conflict confirmation*

I have read the camp dates and performance times, and confirm that the camper does not have any conflicts that would prevent them from attending all camp dates and performances.

Confirmed.

Rehearsal Phone Policy*

During show camp rehearsals, all cast members will place their phones, ipads, smart watches, or similar devices in a designated space. The cast may access their devices during designated breaks or in cases where they need to contact a parent/guardian. Absolutely no cast member will be permitted to record or take photos during rehearsal unless otherwise directed, and only for rehearsal purposes.

I understand.

Publicity Releaase*

We will be taking and sharing photo, sound, and video for promotional purposes.

I agree to allow Elefante Music & School for the Performing Arts to use photographic, sound, and/or video images of this student for promotional purposes.

How did you hear about our Summer Show Camps? If you are totally new to Elefante and were referred to us by another customer, please enter their first and last name and any contact info you have so we can thank that person.*

Cancellation policy*

If you need to cancel your registration, please contact alexisc@elefantemusic.com. Refunds will not be available after July 1, 2026.

I understand.

Payment

Total

You authorize your credit card to be charged for this amount.

Credit Card*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Full Name

CAPTCHA

Click Register ONLY ONCE. Do not refresh your browser or click the Back button. If you click REGISTER and receive an error message, email alexisc@elefantemusic.com (rather than registering again, as in many cases we will still receive your registration).