CSz Adult Improv 101 - Winter 2018 Registration

Thanks for your interest in our Level 1 Winter Improv Training Classes at the CSz Richmond Theater! Please fill out the information below, click submit at the bottom and finish up at our PayPal site to ensure your spot in this class!

Student's Name *

First Name Last Name

Student's Age *

Please note: you must be 18 years or older and no longer in high school to participate in this class.

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number *

Area Code Phone Number

How did you hear about CSz Richmond Improv Classes? *

Returning student Google Search Facebook Local print ad (newpaper, magazine, etc) Groupon or ValPak promotion ComedySportz email newsletter Friend's recommendation Other

Emergency Contact *

First Name Last Name

Emergency Phone *

Area Code Phone Number

Other Emergency Numbers

Please list any medical conditions of which we may need to be aware that might affect movement or any aspect of performance (our stage is ADA compliant!)

MEDICAL PERMISSION

By submitting this electronic registration, I give my permission to CSz Richmond to administer any necessary first aid to the student in case of emergency and, if warranted, to take the student to an emergency clinic or hospital. I understand that CSz Richmond will contact the person listed as an Emergency Contact to inform me of any incidents.

*

I consent to giving medical permission as stated above

Please select the class for which you would like to register. If you are signing up more than one person, please submit this form in its entirety for each individual. Thanks! *

CSz RVA Winter 2018 Improv 101 $ 180.00

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RELEASE OF LIABILITY

In consideration of my participation in the activities of ComedySportz, I hereby fully release and discharge, and save whole and harmless, ComedySportz Richmond, the CSz Richmond Theater, CSzRVA, Yes Balloon, their owners, officers and employees, their successors or affiliates from any and all liability for damages or claims for damages, causes of action, claims, demands, costs, expenses, and compensation of any nature whatsoever, for any and all known and unknown personal injuries, sickness, illness, or disorder, which I may now hereafter have, arising out of or in connection with participation in any activities whatsoever of ComedySportz Richmond, CSz Richmond Theater, CSz Richmond or Yes Balloon.

By submitting this electronic registration, I state that I have read, understood, and willingly sign this release.

*

I acknowledge and accept the release of liability

PHOTOGRAPHY PERMISSION

I give my permission to CSz Richmond to take photographs of this student in class activities for the purposes of promotion and marketing of CSz Improv Classes and training for future use. I understand that these photographs are the property of CSz Richmond. CSz Richmond will provide a copy of any photographs upon request.

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Yes, I agree to give photography permission

Submitting this form will direct you to a PayPal page for payment of the total amount for classes selected. If you would like to register more than one student, please submit the entire form individually for each student.