Backstage Kids 2022 Registration Form

Child's Information

Child #1 Name

First Name Last Name

Child #2 Name

First Name Last Name

Child #3 Name

First Name Last Name

Child #4 Name

First Name Last Name

Child #1 Upcoming Grade

Child #2 Upcoming Grade

Child #3 Upcoming Grade

Child #4 Upcoming Grade

Parent/Guardian Information

Name

First Name Last Name

Cell Number

E-mail

example@example.com

Parent/Guardian Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Emergency Information

Emergency Contact's Name

First Name Last Name

Phone Number

Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.

Please read the following:

I understand that cast auditions will be held on Saturday, June 4 (9am-11am) at Three Rivers Church- 101 Miller Street, St. Marys, GA

I understand that the dress rehearsal on Saturday, July 23 (10am-12pm) at Three Rivers Church- 101 Miller Street, St. Marys, GA is mandatory.

I understand that my child/children may participate in physical activities such as those held during Game Times. As with any physical activity, there is a risk of injury. I fully accept this risk and hold harmless from any legal liability, Three Rivers Church and any persons involved in BackStage Kids Ministries.

In the event that requires medical treatment for the above named child, I understand every effort will be made to contact me or my emergency contact. However, if I/we cannot be reached, I give my permission to the BackStage Kids Ministries volunteers to secure the services of a licensed physician to provide the care necessary for my child’s well being. I assume responsibility for all costs connected to any accident of treatment of my child.

I grant permission for a photo or video of my child to appear in marketing efforts to be used by BackStage Kids Ministries only, so long as there is no identifying information shown (i.e. name, age, etc.)

Registration is $25 per child.

Once you have completed the registration form, click SUBMIT FORM and you will be redirected to complete your payment.

On the payment page- please enter the total amount for registration and select from the dropdown box Backstage Kids.

You will receive confirmation of registration and a list with all of the dates for the musical.

Back Stage Kids Registration