CHM Bible Theatre Productions, Inc.
 Contact Us:
office 217-407-3022 
registration/audition/volunteer line 317-763-0364 
[email protected]

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Registration Form for CHM Youth Arts Summer Camp and After School Care Programs. 

Name of Parent(s): 
Name of Child: 


Emergency Contact: 

Church affiliation/religion or none if not applicable:  
What is(are) your child's talent(s)? 

What grade is your child and which school? 

Which classes will your child be attending 3, 6, 7 or all?

What are your choices? See schedule to choose.

Does your child have any food allergies?  Snacks will be provided.                                                             

Does your child have any toiletry issues or medical conditions? 

Is your child on any medications or any special needs:

The name of the person who will be picking up your child.

Will you permit us to use photos of your child taken during rehearsals, activities and productions for marketing purpose?

After weeks of drama and Improv training, a production may be presented. Will you and your family be able to attend? How many? 

How did you hear about us? 

Would you be interested in using any of your gifts, skills,education or talents in our community large productions? Ages range from 5-75. 

If so, what is your area of interest?

Is there any additional info you would like to share about yourself or your child?  

Signed parent name or responsible party.

Date of Signature: 

Please note, typed name and date entered will be used as your signature.

Cost Breakdown for IBTK Program - This price only good between May 1 thru May 29.  Prices will change on May 30.
Registration Fee - $25.00 
3 classes in June - $20.00 
6 classes in June - $40.00
7 classes in June - $60.00
ALL classes in June - $90.00

Total cost of 3 classes- $45.00 (incl registration fee)
Total cost  of 6 classes- $65.00 (incl registration fee)
Total cost of 7 classes - $85.00 (incl registration fee)
Total cost for ALL classes - $115.00 (incl registration fee)

Payment can be made online, or check by mail to PO Box 7604, Champaign, IL 61826-7604 or by completing credit card info below. 

We are excited that you have registered your child to be a part of our Summer Program! 

Thank you for your Support!

To contact us, click the contact us page or email us at [email protected] or 
call 317-763-0364. You can also write us, PO Box 7604, Champaign, IL 61822

Please complete your credit card information below If you would like for us to make payment for you. We will send you a receipt upon completion. 
Credit Card Number:
Name on Card:
Billing Address:

Payment is Secured
Would you like the receipt to be sent by email or mail?
Thank YOU!
Total charge amount to credit card:   $