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Actor Registration & Safety Form
Please fill out completely before your first class.
15
Questions
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1
Student Name
*
This field is required.
Please write the preferred stage name of the performing actor.
First Name
Last Name
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2
Email
*
This field is required.
Minors should input their parent or guardian's email.
example@example.com
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3
Phone Number
*
This field is required.
Minors should input their parent of guardian's phone number
Area Code
Phone Number
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4
Known Food Allergies
Please let us know of any allergies that could prevent a positive experience in class or at our facility.
You may put "N/A" if applicable.
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5
Emergency Contact
Please list an emergency name, phone number, and relationship, if an emergency were to arise during a training session.
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6
Attention to Educational and Medical Needs
Please let us know of any medical or educational conditions or restrictions. Take note that our classes involve breathing techniques, physical body movement, camera lighting, vocal exercises, script reading, public performances and reading comprehension. *This information shall remain confidential between actor and the instructor.
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7
Bathroom Permission
*
This field is required.
I give permission for in-STUDIO instructors to permit my child (myself) to walk to the bathroom independently. To assist the staff with this situation, I will allow my child and/or myself ample time to use the restroom prior to entering class. Additionally, in-STUDIO instructors are not permitted to enter a bathroom while it is occupied with another actor or client, regardless of reason.
YES
NO
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8
Release of Liability
*
This field is required.
I am aware that actor training and the exercises associated with it place emotional demands on the body and mind. On behalf of my child and myself (and I am no longer a minor, on my behalf), I assume the risk and agree that in-STUDIO, LLC shall not be liable in any way for injuries sustained during attendance at the studio or any of its related functions. It is also understood that actor education may include physical contact from the instructor or fellow students as part of regular class work.
YES
NO
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9
Photo & Video Release
*
This field is required.
I hereby give in-STUDIO’s videographer and/or photographers the right and permission to copyright, use, reuse, publish, and republish photographic pictures of my child or myself, or reproductions thereof, in color or black and white for any purposes whatsoever, including the use of any printed matter in conjunction therewith. I hereby waive any right to inspect or approve the finished photograph and/or advertising copy or printed matter that may be used in conjunction therewith or to the eventual use that it might be applied. I hereby release in-STUDIO from any liability as a result of any distortion, blurring, alteration, optical illusion, or use in composite form, whether intentionally or otherwise, that may occur or be produced in the taking, processing, or reproduction of the finished product, its publication, or distribution of the same. I have read the foregoing release, authorization, and agreement and warrant that I fully understand the contents thereof.
YES
NO
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10
Studio Handbook
*
This field is required.
I understand that all actors are responsible for the written policies, expectations and contents found within the student handbook, regardless of whether they choose to read it. The handbook is located in the "More" section of our website.
YES
NO
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11
Tuition
*
This field is required.
I understand how the studio works and the enrollment process, including when tuition is due and how fees are assessed. This includes non-refundable deposits and the time limits for requesting a refund or transfer of studio credit. This information is made clear in our Student Handbook, which is found in the "More" section of our website.
YES
NO
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12
Arrival/Departure
*
This field is required.
I understand that actors may enter the facility no more than 10 minutes before the start of their class. I also understand that instructors are not responsible for students more than 10 minutes after class has ended. For parents or guardians who fail to pick up their child in a timely manner, a fee of $20 may be assigned to the next invoice for childcare responsibilities.
YES
NO
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13
Picking Up Minors
*
This field is required.
I agree to inform in-STUDIO staff of who will pick up minor aged children and ensure they are aware that an ID may be requested. in-STUDIO will not be held liable for any pick up of a minor, if the parent or guardian fails to provide this information. It shall be assumed a parent or guardian of the child actor will always pick them up from our facilities.
YES
NO
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14
Third Party Transportation
*
This field is required.
Families who decide to allow their students under the age of 18 to use an alternate transportation plan (i.e. a city bus, taxi, Uber, Lyft, etc.) must agree to this by clicking YES. By doing so, they release, waive, discharge and covenant not to sue in-STUDIO, LLC, its staff, or instructors (hereinafter referred to as releasees) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage, or injury, including death, that may be sustained by my minor child(ren) or me, or any of the property belonging to me or them, as a result of, or in any way arising out of my child(ren) traveling to and/or from in-STUDIO or an in-STUDIO, LLC event. By clicking YES, you further agree to indemnify and hold harmless the releasees from any loss, liability, damage or costs arising in any way out of my child(ren) traveling to and/or from in-STUDIO or an in-STUDIO, LLC event using an alternate transportation plan.
YES
NO
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15
Signature of Completion
I agree and understand that by signing the Electronic Signature Acknowledgment and Consent Form, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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