Stage Combat FUNdamentals
A storytelling workshop with John Patrick Hayden; Sunday, February 26th, 2023
To register for the "Stage Combat FUNdamentals" storytelling workshop, please complete the form below.
Registration fee of $40 per participant is due upon arrival to workshop (cash, check, or Studio Director account). All students must have a signed PSPA Waiver to participate in this workshop.
Which workshop session are you interested in?
Session 1: Ages 9 - 17; Sunday February 26th 12:30 - 2:30 PM
Session 2: Ages 18+; Sunday February 26th 3:00 - 5:00 PM
PARTICIPANT INFORMATION:
Please provide the following information about the workshop participant. If you would like to register multiple participants, please submit a second form and waiver.
Participant's Full Name
First Name
Last Name
Participant's Birthday
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Month
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Day
Year
Date
Participant's Age
Phone Number
Please enter a valid phone number.
Email Address (for receiving workshop communications)
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If the participant is under the age of 18 years of age, who will be dropping off and picking up the participant?
Does this participant have any allergies/medical concerns you'd like us to be aware of?
Emergency Contact Information
Please provide information for an emergency contact.
Emergency Contact Name
First Name
Last Name
Relationship to the Participant
Phone Number
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Alternate Phone Number
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Workshop Participation Waiver
Please read and acknowledge the following policies by signing below:
Acknowledgement of PSPA Policies Regarding Liability & Permissions:
I/We hereby waive, release, absolve, indemnify, and agree to hold harmless PSPA, their agents, volunteers, staff, assistants, officers, Board of Directors, members, from any and all claims, suits, damages, attorney’s fees, court costs, or loss resulting from any cause whatsoever, including negligence, arising out of myself and my child’s participation in classes, rehearsals, other activities, and performances, of PSPA. I/My child is in good physical health. I/We hereby give my/our permission to call for the medical attention required for illness or injury while attending PSPA. I/We agree that PSPA, its staff, assistants, members, officers, and Board of Directors shall not be responsible for any medical fees. PSPA reserves the right to dismiss a student or family member from any PSPA classes/events for not following the PSPA policies & procedures and in the event of any communicable illness (i.e. COVID- 19, flu, chickenpox, lice, H1N1, etc.). I/We give permission to take/use photographs/videos of me/my child participating in classes, performances, and activities for promotional use.
Signature
By signing above I acknowledge and accept the policies noted above regarding workshop participation.
Submit
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