Summer Youth Program 2023

General Information
Participant Name

First NameLast Name
Participant Date of Birth

MonthDayYear
Date
Participant Email
example@example.com
Participant Phone
Please enter a valid phone number.
Participant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian

First NameLast Name
Parent/Guardian Phone*
Please enter a valid phone number.
Parent/Guardian Email
example@example.com

Medical Release

To be signed by parent or legal guardian OR by participant if age 18 or older.
Known Allergies (Medicine/Food):
Emergency Contacts*
I, {parentguardian}, hereby give permission for any and all medical attention necessary to be administered to me/my child, {participantName}, by staff/volunteer(s) of Opera Naples, Inc. in the event of any accident, injury, or sickness.

If in the event of a life-threatening emergency, Opera Naples, Inc. will make every reasonable effort to contact the parent(s) and/or the above designated emergency contacts immediately following contact of the appropriate emergency response individuals. If emergency response services are rendered, I hereby assume all responsibility for payment of such services, and I will not hold Opera Naples, Inc. or its staff or volunteer(s) liable.
Parent/Guardian Signature

Powered by Jotform SignClear
Participant Signature (if over 18)

Powered by Jotform SignClear

Photo / Image Release

To be signed by parent or legal guardian OR by participant if age 18 or older.
I, {parentguardian}, hereby give my consent for Opera Naples, Inc. staff, volunteers, or various news media outlets to take photographs or make videos of me/my child, {participantName}, while he/she is rehearsing or performing Opera Naples’ 2022 summer youth program. I understand that all photographs and videos of my child become the property of Opera Naples, Inc. and may be used in future promotions and publications distributed by Opera Naples, Inc. including, but not limited to, brochures, press releases, Opera Naples Facebook page, and Opera Naples website.

I release Opera Naples, Inc. from all claims I may have to the use of said photographs or videos.
Parent/Guardian Signature

Powered by Jotform SignClear
Participant Signature (if over 18)

Powered by Jotform SignClear

Release of Liability

To be signed by parent or legal guardian OR by participant if age 18 or older.
As consideration for participation in the Opera Naples Summer Youth Program:

I understand that as a participant, I/my child may be climbing on and off stage and set pieces, as well as moving between various spaces including rehearsal rooms, dressing rooms, the stage, etc. I further understand that I/my child may be running, jumping, dancing, and executing varied other movements on stage.

COVID-19 Warning and Disclaimer
COVID-19 is a highly contagious virus that spreads easily through person-to-person contact and can lead to severe illness, permanent disability, and death. Participating in the Opera Naples program could increase the risk of contracting COVID-19. Opera Naples in no way warrants that COVID-19 infection will not occur through participation in Opera Naples programs.

I assume all risks and hazards to such participation including transportation to and from rehearsals and performances and hereby waive, release, absolve and indemnify and agree to hold harmless, Opera Naples, its organizers, sponsors, supervisors, and participants for any claim arising out of accidental injury to my child. My signature indicates that I have read, understand, and agree to the terms of this Release of Liability. I hereby assume all risks of personal injury and property damage that may result from any Opera Naples, Inc. activity.
Parent/Guardian Signature

Powered by Jotform SignClear
Participant Signature (if over 18)

Powered by Jotform SignClear
This form only applies to participants who are under the age of 18. A parent/guardian is asked to complete this form.

Driving / Walking Options
Participants should bring lunch with them daily; however, it is not prohibited for participants to walk or drive offsite to get lunch. The location of the program is next to Narrative Coffee and across the street from The Bowl. Anticipating that some will ask to walk to these locations during lunch breaks, permission to walk offsite has been included.
Driving - Choose One Option
Select I give permission for {participantName} to ride with any driving program participant.
Select I give permission for {participantName} to ride with only this or these driver(s): Allowed Drivers
Select I do not give permission for {participantName} to ride with any participants.
Walking - Choose One Option
Select I give permission for {participantName} to walk to The Bowl or Narrative Coffee with one or more other participants.
Select I do not give permission for {participantName} to walk to The Bowl or Narrative Coffee.
Parent/Guardian Signature

Powered by Jotform SignClear
*Opera Naples will not be held liable for any injuries that may occur to participants who are driving or riding in other participants’ vehicles during the 2023 youth summer program.

Payment / Sponsorship Application

Please select an option from the menu below to proceed.
Select I would like to Pay for the Summer Youth Program now.
Select I would like to Submit a Sponsorship Application

Payment

Summer Youth Program Payment

Summer Youth Program

$450.00 Quantity
Item subtotal:$0.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please be sure to click submit after completing payment form to complete your registration process.

General Information

Medical Release

Photo / Image Release

Release of Liability

Driving / Walking Options

Driving - Choose One Option

Walking - Choose One Option

Payment / Sponsorship Application

Payment

Sponsorship Application