Registration

Summer Theater Camp daily sessions will be at the Urbana Youth Center, 160 W. Market St. Urbana, Ohio. Camp is from 9:00am-5:00pm Monday through Friday the weeks of June 16-25, 2025. Auditions will be held Saturday June 14th from 10:00 am to 2:00 pm. We have added a half day of camp on Saturday, June 21st from 12 pm to 5 pm this year. All students who have enrolled and paid the full tuition by 06/07/25 will have a part in the show. One T-Shirt is included for each student as part of their camp tuition. Parents may order additional T-Shirts by completing the order form found at the bottom of the registration page and paying online.

Performances will be held at the historic Gloria Theatre 216 S. Main St. Urbana, Ohio on Thursday, June 26th at 7:00 pm, Friday, June 27th at 7:00pm and Saturday, June 28th at 2:00pm. Show call times for each performance are: Thursday and Friday 1:00 pm and Saturday 11:00 am

Students in need of a partial tuition scholarship may request an application once registered by sending an e-mail to [email protected] or by launching the embedded fillable web form at the bottom of this page. Completed scholarship applications must be returned to us via e-mail by May 18, 2025. Due to a generous grant awarded by the Mental Health Drug and Alcohol Services organization we have several $150 scholarships available for students residing in Champaign and Logan Counties this year. If your student applies for and receives a scholarship of $150 then no other fees will be due (so camp for two weeks would only cost $100). We have a limited number of scholarships available to students residing in other counties so if you are in need of one apply right away. The deposit of $100 must be paid first.

Please complete the form below to register online. The camp fee is $250 for early registration prior to June 1st or $270 beginning on June 1st. A $9 fee for processing costs applies when paid via credit card. A $100 deposit and a signed consent for emergency care and waiver of liability along with a signed video and photo release and code of conduct must be received in order for registration to be complete. Without the receipt of the $100 deposit your student's spot at camp is not guaranteed. Students must also complete the Getting To Know You form as soon as they are registered and the deposit has been paid. The Getting To Know You form must be submitted by June 7, 2025.

Full tuition must be received by June 7th for all students enrolled by June 1st. The camp fee is fully refundable through May. Beginning June 1st the cancellation fee is $50.00. If registering on or after June 1st, the full tuition amount is due at the time the student is enrolled. The registration deadline is June 7, 2025.

Attention Parents: Registration for 2025 Camp is now closed. Please join us for one of our three performances at The Gloria Theatre on June 26-28. For tickets follow the link below: https://gloriatheatre.org/tickets/p/nrhehlc6eyjznyr-5937n-72krp-z7c95-tzlp4-fetxm

Summer Theater Camp 2025 Registration Form
A separate form is needed for each student. Registration deadline is June 7, 2025

Student Information

* Indicates required field

First Name *

Last Name *

Age *

School *

Grade *

Gender *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Mobile Number *

T-Shirt Size *

Registration includes one shirt per child. Additional shirts may be ordered for students or family members. See links at the bottom of the page to order and pay for extra shirts.

Permission to text? *

Yes No

Parent Information

Parent 1 First & Last Name *

First

Last

Parent 1 Email *

Parent 1 Mobile Phone *

Permission to text? *

Yes No

Additional Contact Information

Addtl. Contact/ Parent 2 Name *

First

Last

Addtl. Contact/ Parent 2 Email *

Relationship to Student *

Addtl. Contact/ Parent 2 Mobile Phone *

Permission to text? *

Yes No

Please list any medical or physical concerns, any allergies, and any current medications required for your student.

Medical Concerns *

CONSENT FOR EMERGENCY CARE AND WAIVER OF LIABILITY I understand and grant to any medical doctor or hospital my consent to render such aid or treatment to my child, _________________________________ in the event he/she should be injured or become ill while participating. I further understand that the staff of Summer Theater Camp are not liable in the unlikely case of an accident or injury. Type in child's name below.

Student Name- ER Waiver *

Photograph and Video Release Form SUMMER THEATER CAMP FOR YOUTH would like to use photographs and videos from camp in our promotional materials, on our Facebook page and on the theater camp web site. Images may be used for digital media and/or printing purposes without my inspection prior to the finished product. By completing this release form, I give my permission for photos, audio, and video of my child, ______________________________________ to be used by Summer Theater Camp. Type in child's name below.

Student Name- Photo *

CODE OF CONDUCT - Summer Theater Camp for Youth

BE A RESPECTFUL TEAM MEMBER AND BE COOPERATIVE. Take direction willingly and with a positive attitude. Stay focused on the show without drawing unnecessary attention to oneself. Be supportive and respectful towards all cast members, staff and volunteers. Handle props, set, and costumes with care. Harassment or insubordination of any kind WILL NOT be tolerated.
BE RESPONSIBLE AND PLAN AHEAD. Do not miss any of camp/auditions for appointments, work, etc. Learn lines, music and choreography as quickly as possible and ask for help if needed. Come to camp each day with everything needed (i.e. a script, worksheets, sheet music, pencils and highlighters, a good lunch and plenty of water).
BE SAFE AND MAINTAIN YOUR OWN PERSONAL SPACE with no PDA, horseplay, rough-housing, sitting on other’s laps, bear hugs, etc. Students should stay in common spaces within each building. When crossing the street between the youth center and the theater, students should be in a group of at least 3 and have adult supervision.
COSTUMES - All costumes and character accessories/ makeup provided by staff are to be taken care of as directed (i.e hang them up, keep pieces together, etc.) Some characters require an actor/ actress to alter their appearance to fit the role (i.e. wigs and special effects makeup), students should accept these additional requirements without complaint. It is the student’s responsibility to leave their shoes, socks, undershirts/camisoles and shorts, etc. at camp starting the Monday of the 2nd week.
PHONE POLICY- Phones will only be in students’ possessions during lunchtime. If a special need arises to use a phone, ask a staff member. PHONES WILL NOT BE ALLOWED AT THE GLORIA THEATRE as they could interfere with the body mics. We ask the audience to turn theirs off as well.
NO GUM is permitted to be chewed during camp as it interferes with singing and is a safety hazard. Please leave this at home.

I understand that we all want the best camp experience for everyone involved and there will be only one warning if these guidelines are not followed. That warning will be signed and dated by the student, staff and parent and must be returned to camp the following day. Upon further infractions, the student will be dismissed from camp with only a $50.00 refund to the parent. Depending on the severity of the misconduct the student may not be invited to return to camp in future years. This form must be signed with the registration. A paper copy with physical signatures by both parent and student will also be required prior to camp. A paper copy of the form will be provided when you pick up your student's T-shirt and script.

PARENT SIGNATURE CODE OF CONDUCT *

STUDENT SIGNATURE CODE OF CONDUCT *

I confirm that I am the Parent or Guardian for the student listed. I give my permission for the student to attend Summer Theater Camp For Youth and also agree to the CONSENT FOR EMERGENCY CARE AND WAIVER OF LIABILITY and the Photograph and Video Release Form reference above by submitting this registration form. *

Agree

Today's Date *

Submit

PAYMENT

A deposit of $100.00 or full tuition payment must accompany your child’s registration form to guarantee a place in this year’s camp. Without the receipt of the $100 deposit your student's spot at camp is not guaranteed. Payment can be made online through the below options or by check. Please make checks payable to SUMMER THEATER CAMP FOR YOUTH and mail to: Mrs. Lynn Adell Mirtes, 1443 Three Mile Rd, Urbana, Ohio 43078.

Camp Registration Deposit ($100): https://square.link/u/XwoN9nm8
Balance of Camp Tuition ($150 + $9 processing fee): https://square.link/u/uAVBXV3Y

Full Camp Tuition - Early Enrollment - $250 + $9 processing fee (by 05-31-25): https://square.link/u/8wHuZPf6
Full Camp Tuition - Late Enrollment - $270 + $9 processing fee (after 06-01-25): https://square.link/u/ZiByUHOe

Extra T-Shirt Orders - place orders by completing the form at the following link: https://forms.gle/6ChqonnjrBqLN8Uh6
Payment for extra shirts can be made via Square ($15.75 to $19.75 Per shirt – Enter the Grand Total of your order): https://square.link/u/tmUhAMd1

REGISTRATION

Summer Theater Camp 2025 Registration FormA separate form is needed for each student. Registration deadline is June 7, 2025

PAYMENT

Summer Theater Camp 2025 Registration Form
A separate form is needed for each student. Registration deadline is June 7, 2025