THEATRe programming summer 2022 WIZARD OF OZ July 25-Aug 6
Rhode Island Youth Theatre
How many students are you registering? (20% discount for siblings)
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1
2
3
Student Name (How it will appear on the program)
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First Name
Last Name
Age
Sibling 1 Name (How it will appear on the program)
First Name
Last Name
Age Sibling 1
Sibling 2 Name (How it will appear on the program)
First Name
Last Name
Age Sibling 2
Address
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Street Address Line 2
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Parent or Guardian Name 1:
First Name
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Parent or Guardian Email 1:
example@example.com
Parent or Guardian Name 2:
First Name
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Parent or Guardian Email 2:
example@example.com
Emergency Contact:
First Name
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Emergency Contact Phone:
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StudentE-mail:
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T_Shirt Size
Children S
Children M
Children L
Children XL
Adult S
Adult M
Adult L
Food Allergy
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If answer is yes, please explain.
Dismissal - Will the student be signed out each day?
Yes
No
If Answered yes, by whom? (ID required)
Any custodial or medical Issues?
Does your child do gymnastics?
If answer is yes, please list what tricks they have permission to do at rehearsal and in shows.
Photo Release: Do you give your permission for your child's photo to be used for promotion material for RIYT?
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What program are you registering for?
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Wizard of Oz Youth Edition
$
500.00
Historic Park Theatre, 848 Park Avenue, CranstonAges 7-16Reg. Fee $5009 am to 3 pm July 25-29 and Aug 1-5; early drop off 8:30 am. Shows 10 am and 7 pm Friday Aug 5 and 7 pm Sat. Aug. 6Directors: Kelly Hooper and Grant WhitneyMusic Director: Cooper Cardone
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Liability Release/Emergency Treatment: I certify that my child may tolerate all normal physical activity. I, the undersigned parent/guardian grant permission for my child to receive the necessary medical treatment in the event s/he sustains an injury or illness during my absence. I understand that if my child has a medical condition that requires an assigned assistant in a school setting, then either I or the child’s assistant must be present at all times. I acknowledge and understand that participation in this activity presents the possibility that my child may sustain physical injury or illness. I hereby release Rhode Island Youth Theatre, its employees, officials, and agents from any liability connected to my child’s participation in the program. -Parent/Guardian Signature
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