Registration Packet

Please complete this form once you have registered for a Summer Camp program at Center Stage Children’s Theater
Mission Hills United Church of Christ 4070 Jackdaw Street San Diego, Ca 92103

Summer Camp 2025 at CSCT
The following information must be completed by the parents/legal guardians of campers who are already registered for Summer Camp at CSCT. If you are not registered and wish to do so, you can register for all camp sessions using the the online store. Please read the following documents carefully. These forms must be completed before the first day of camp!!

Registration Form *required information

Does your child have other allergies? (such as bee stings, foods) *

Yes No

If yes, please list allergies and reactions: *

Please provide any additional information about the participant’s behavior and physical, emotional, or mental health so that we may better serve your child. *

Participation/Permission Slip & Release I hereby authorize my child to participate in the Center Stage Children’s Theater Summer Camp; to travel off site to the park for lunch and camp related activities. I release Center Stage Children’s Theater and its employees from any liability, claims, damage, or expense sustained by my child in connection with such participation *

First

Last

In case of injury while at the program, I give permission for my child to be taken to a hospital for treatment, including evaluation for injuries, x-ray, and any needed care. I understand the staff will make every effort to contact me in case injury occurs *

Yes No

Sunscreen permission for application *

PERMISSION TO APPLY SUNSCREEN: I give CSCT staff permission to apply sunscreen, which I will provide, to my child during the camp day. PERMISSION TO APPLY SUNSCREEN: I give CSCT staff permission to apply sunscreen, provided by CSCT with an SPF of 15 or higher. I DO NOT GIVE PERMISSION TO APPLY SUNSCREEN TO MY CHILD.

I, the parent/legal guardian, give permission for the following person or persons to pick up my child from CSCT Summer Camp. (CSCT will only release each camper to a parent or legal guardian unless this authorization is submitted.) *

*Health staff cannot administer medication. Child must be capable of administering it themselves under the supervision of the Health Director, including epi-pens.

Cell Phone Policy:
At CSCT, we have a no cell phone policy. Cell phones are not to be brought to CSCT, or need to be left in their backpacks turned off for the duration of their time at CSCT. If you need to get a hold of your child, please call or text the director Rosy Dawn Selwitz at 760-586-1932

Behavior Management Polices
Please read and discuss the following rules and consequences with your child.
Philosophy:
Center Stage Children’s Theater Staff recognizes and respects children as people with unique feelings, values, and needs. We believe that positive reinforcement and behavior modification through consequences are effective methods of interactions, particularly when dealing with b!ehavior problems.
Rules:
At CSCT, we follow the Four “R’s:”
Respect the staff—listen and follow directions
Respect the theater and church property
Respect others—be friendly, listen and share with other kids at CSCT; keep your hands and feet to yourself
Respect yourself—take care of yourself and your belongings
Behavior Management Procedures:
Positive verbal recognition and rewards will be used consistently to reinforce good behavior. Rewards can be as simple as individual attention from an adult or a special activity. The following steps will be taken in the event of behavioral problems:

1. Reasoning: Communication between the child and staff member to identify the problem and determine a possible solution. At this point, children are given a chance to explain what happened and to make a choice about what they should do next.

2. Removal/loss of privilege: Removal from the activity for a short period of time. This allows the child to gain control of a difficult situation. Time outs can include activities which might lead the child to consider alternate behaviors. The staff might ask that they make a short list of alternate ways to handle the situation, write or draw a letter of apology, or perform a short community service project.

3. “Think and Writes”: In a case where reasoning and time outs have failed, or when a child has had 3 consecutive time outs, the child will complete a “think and write”. ‘‘Think and writes’’ allow the child to document what rule they have broken, what consequence they received, and what they will do next time to avoid breaking the rules. Parents will be notified when they pick up their child. All “think and writes’’ will be filed and kept confidential.

4. Parent Conference: An informal parent conference will occur when repeated behavior problems occur and/or when a behavior is particularly dangerous to the child, staff, or other children. Parents, the Child, Camp Director, and Program Director will discuss the behavior and possible solutions. Future consequences for continued behavior and future rewards for improved behavior will be agreed upon and documented at this time.!

5. Suspension/Dismissal: If the agreement is not upheld, another meeting will be held with the child, staff and parents. At this time, a short term (up to 1 day) or long term suspension will be required and a discussion as to whether this is the right program for your child will occur. If the suspension is not effective, the child will be dismissed from the program. Refunds will not be given for suspensions or dismissals.!
Parents should always be aware that if your child behaves in a way that puts him/herself, staff, or other children in danger (violent behavior, threats toward or striking staff, running away from the Club or Site), you will be called and asked to pick up your child immediately regardless of previous behavior. A suspension will immediately be effective for any such behavior.

Refund Policy
We do not offer refunds or cancellations for any reason except medical or family emergencies. If your reason for refund is approved, a $25 cancellation fee will apply. An additional prorated amount will apply if the child attended any days of camp.

I have read and agreed to all policies and procedures listed in the Behavioral Management Policy of CSCT. I will direct all questions about these policies to the Program Director. My child and I will discuss the CSCT rules and consequences for not following the rules, outlined in the Behavior Management Policy. My child and I agree to support the rules and consequences detailed in the CSCT’s Behavior Management Policy. *

Yes No

Choose One *

I/We GRANT permission to use my child’s photo/image to be published on the Center Stage Children’s Theater public Internet site, news media, and any other promotional material. I/We DO NOT GRANT permission to use any photo/image or information that includes my child for any reason.