Camp Roxy Application

A deposit payment of $30 is required to reserve your spot in the camp, the remaining balance will be due the first day of camp.

Student Information

Name

First Name

Last Name

Camps Child Wishes to Attend

Roxy Arts Intensive (Ages 13-16)

Camp Roxy Performance Camp (Ages 6-12)

T-Shirt Size

Age:

Date of Birth

Gender

Female

Male

Conditions, Medications, Allergies

Please state any conditions, medications, and any allergies of which the Roxy staff needs to be made aware.

Parent / Guardian Information

Name

First Name

Last Name

Mailing Address

Phone

(###)

###

####

Email

In Case of an Emergency Contact

Name 1

First Name

Last Name

Phone

(###)

###

####

Name 2

First Name

Last Name

Phone

(###)

###

####

Authorization of Emergency Care:

I hereby authorize physician, surgeon, or dentist on the medical staff of the nearest facility in Oklahoma, to administer any emergency treatment procedure or medicine necessary or advisable when Oxford Production's staff accompany my child to the emergency room at the nearest medical facility. I also authorize Oxford Production's staff to secure the use of an ambulance, if necessary for transporting my child to the hospital. I further agree to pay the hospital, doctors, and ambulance service for all services rendered to the above-named patient. I request that this authorization remain in force as long as my child is enrolled as a participant in Oxford Production's Camp Roxy.

Signature:

I authorize emergency care

Photo Release:

I hereby give Oxford Productions the authority to use any photography/videotape footage of my child for public relations purposes.

Signature:

I authorize photo release

Liability Release:

I am the parent/guardian of my child who is participation in Oxford Product's Camp Roxy. It is my understanding that Oxford Productions and all persons acting on its behalf will do their utmost to assure that my child will be safe at all times. Nonetheless, I understand that this camp involves a high level of physical activity and Oxford Productions cannot assume responsibility for any injury which may occur.

Signature:

I authorize liability release of my child

Cost:

Early Bird Tuition: $70.00 per week Standard Tuition: $75.00 per week (Includes Camp t-shirt, daily snack and all performance materials) A deposit payment of $30.00 is required to reserve your spot in the camp, the remaining balance will be due the first day of camp.

Payment Option: Please select payment that you'll be including

Full or Partial Scholarship (Please email scholarship application to roxymuskogee@gmail.com) Mail a Check (Payable to Oxford Productions, Inc) Pay Online (Transactions will be charged a processing fee)

Camp Roxy Application Deposit

$30.00

A deposit payment of $30 is required to reserve your spot in the camp, the remaining balance will be due the first day of camp.

Quantity:

Add To Cart

Scholarship Application

Learn more

Scholarship Application

Date of Application and Student Name

Please return this application with the enrollment form.

Indicate your need:

Full Scholarship

Partial Scholarship

How much are you able to pay?

How far do you travel to camp?

School System? (i.e. Muskogee Public Schools, Hilldale, etc)

Please describe the need for the financial assistance:

Please list other involvements, or organizations in which your students participate:

Please describe why this camp is important for your student to attend: