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Katia & Company

Non-profit theatre company

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Cruel Summer Camp Registration

Participant Name*

Preferred name and pronouns, if different

Grade in fall 2025*

Sibling participating, if any

Parent info

Parent name*

Parent email*

Phone number 1*

Phone numer 2*

Emergency phone number to contact in the event that parents cannot be reached*

Dates and location*

Novato, July 7-11 WAITLIST0

Larkspur, July 14-18 WAITLIST0

San Anselmo, July 28-August 1588

Optional add ons

Aftercare M-Th, until 4pm80

Hot lunch M-Fri65

K&Co T-shirt15

I have read and agree to the terms of the waiver.

Does your child have any allergies, medical conditions, or developmental concerns we should know about?

If your child has a birthday during camp, let us know!

Katia & Company

503 South Palm Drive Novato, CA

tax ID 82-222-7982

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