Register for the Hilltown Youth Summer Workshop! Please let us know how you will be sending documents: Current Immunizations and COVID vaccination proof Email to hilltownyouth@gmail.com Mail to: Hilltown Youth Performing Arts Program 49 Conway Street, Shelburne Falls, MA 01370 Upload documents here Up-to-date physical and immunization records Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Please click here to upload your childn's immunization records. Thank you! Proof of COVID vaccination for anyone over the age of 12Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.Student Name* First Last Date of Birth* MM slash DD slash YYYY Primary PhoneEmail Receive updates and monthly newsletters? 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KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Emergency Contact Information:* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email Any allergies we should know about?* 1) Tell us about your interest in theater and circus arts?2) What are you passionate about?3) What brings you joy?4) What if any goals do you have for yourself this summer?5) Do you play an instrument?6) Do you enjoy building things? Including community and sets...7) Do you enjoy painting stuff, on canvas or objects?8) Tell us anything else about yourself you want us to know.HYT Summer Workshop Fee Price: $900.00 Quantity: How will you be paying for the HYT Summer Workshop?*Cash (Due 4 weeks prior to when event/workshop begins)Check (Due 4 weeks prior to when event/workshop begins)Online PaymentFinancial ScholarshipDuring the pandemic, all HYT are pay what you can programs.Upload your filled out Liability FormAccepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB.Liability form can be found here: https://hilltownyouth.org/wp-content/uploads/2021/07/HYTP-Waiver.pdf Upload your filled out Medical Release, permission to treat. Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Medical release form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/Mass-Health-Medical-Release-Form-1.pdf Upload your filled out Berkshire East Waiver for Aerial Park Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Waiver form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/Aerial-and-Netted-park.pdf Upload your filled out Berkshire East Waiver for Rafting Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Waiver form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/Berkshire-Rafting-Waiver.pdf Upload your filled out Berkshire East Waiver for Mountain Coaster Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Waiver form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/mountain-coaster-waiver.pdf Upload your filled out Berkshire East Waiver for Zipline Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Waiver form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/ZipWaiver2022.pdf Upload your filled out Berkshire East Waiver for Chairlift and Turbine Tour Drop files here or Select files Accepted file types: jpeg, gif, png, pdf, Max. file size: 256 MB. Waiver form can be found here: https://hilltownyouth.org/wp-content/uploads/2023/01/Chairlift-Turbine-Tour-Waiver.pdf EmailThis field is for validation purposes and should be left unchanged.
