Opera Storytellers Registration Form

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Camper One Name

Camper One Date of Birth

Camper Two Name

Camper Two Date of Birth

Mailing Address (Street, City, State, Zip)

Home Telephone

Cell Phone

Email Address(s)

Emergency Contact Name

Emergency Contact Phone Number(s)

Pediatrician Name

Hospital or Urgent Care Preference

Insurance Provider

Insurance Member ID Number

Please indicate need for special accommodations and/or any dietary restrictions

Camp Tuition $495 per Camper

Camp Tuition $450 per each additional Camper

TOTAL Amount Due

By submitting Registration I commit to total due. Opera Staff will be in touch to process payment.