VIRTUAL SUMMER ACTING INTENSIVE

Student Information 2026

Student First Name

Student Last Name

Student Age on First Day of Camp

Birthday

Month

Day

Year

Student Email

Student Phone Number

Student's Current School

Student Address

Student Gender

Male

Female

Non-Binary

Parent Information

(Legal Adult Students Skip This Section)

Parent/Guardian First and Last Names

Parent Email Address (If different from Student Above)

Parent Phone Number (If different from Student Above)

Parent Address (If different from Student Above)

Parent Occupation

If Applicable: Custodial Parent

Questionnaire

How did you hear about our Summer Acting Intensive? (Please let us know whom to thank for their recommendation because we never advertise!)

Preferred Method of Contact

Parent Email

Parent Cell Phone

Student Email

Smoke Signals

What other services might you be interested in? We also offer Weekly On-Going Scene Study Classes, Private Coaching, Private Lessons, and Expert Career Consultations!

If you are also interested in joining an On-Going Scene Study Class, or scheduling a Private Coaching, Private Lesson, or a Career Consultation please just let us know!

Has the student had any previous acting instruction? If yes, please provide details of the student's training background. Where, and with whom, has the student studied?

What are some of the parts the student has played - in what and where?

With whom is the student currently represented (if any)? (Theatrically/Commercially)

Does the student have a learning disability, special needs, serious allergies, or special medical needs? If so, please explain.

Why do you want to take this Acting Intensive?

What are you looking for in this Acting Intensive?

Why did you choose Cynthia Bain's Young Actor Studio?

What are some of the student's favorite Films, TV Shows, YouTubers, Internet Productions, and Plays?

File upload

Refund Policy and Disclaimer and Release

All tuition payments and deposits are non-refundable and non-transferrable. There are no refunds or transfers of any kind, including late arrivals, early withdrawals, non-arrivals, booking a job, or dismissal. Fees do not include outside medical care or prescriptions, transportation, to and from camp, or housing while in the Los Angeles area.

This Summer Acting Camp Intensive is held entirely Virtually.

Virtual Summer Intensive Tuition Information:

A deposit of 998. is required to hold your spot in camp. Balance of 897. due by June 1, 2025:Total for the week including the INDUSTRY SHOW: 1895.

Parental Release

I understand that threats, acts of violence, drug use, unruly behavior, or sexual contact of any kind result in immediate dismissal from camp with no refund. I, the undersigned, fully understand and agree that the organizers, owners, instructors, counselors, and administrators of Cynthia Bain’s Acting Intensive Summer Camp shall be free from any liability of claims arising by reason of any injury or illness during the camp session.

I understand that student activities may be documented during the camp sessions. I give Cynthia Bain’s Young Actor Studio permission to use photos, video, or voice recordings of my child in productions for public relations, marketing, archival, and other purposes in keeping with the mission of the school.

I have read and understood all of the above including the Refund Policy. By signing this application electronically, I hereby agree to all stated rules and certify that all information I have submitted for this application is complete and true to the best of my knowledge. I understand that knowingly providing false, incomplete, or misleading information may be grounds for denial or dismissal from camp.

I have read and acknowledged all of the Policies listed above. I authorize Cynthia Bain's Young Actor Studio to charge 998 deposit to the Credit Card I have on file in my Personal Portal.

If you have not yet registered and created your Personal Portal, please click HERE and add your payment information.

I Have Read and Agree to Above

Yes