Piti Theatre Youth Troupe Registration Form 2024

Piti Theatre Company

Youth Troupe Registration and Release Form, Fall 2024

(Skip any fields that do not apply)

I am registering for

Greenfield Youth TroupeShelburne Falls Youth Troupe

First Child's Name

Age

Grade

School

Second Child's Name

Age

Grade

School

Third Child's Name

Age

Grade

School

Parent/Adult 1 (parent primarily responsible for child(ren)'s schedule)

Name

Email

Home phone

Work phone

Cell phone

Address

Street Address Line 2

City

Zip

Parent/Adult 2

Name

Email

example@example.com

Home phone

Work phone

Cell

Address

Street Address Line 2

City

Zip

Is there anything in particular we should know about your child(ren) that might help us help them enjoy being in Youth Troupe more or participate more fully?

Medical Information (Please note any medical conditions we should be aware of, such as asthma, or allergies to foods or bee stings-if you would like a staff member to administer an injection in case of a bee sting, be certain to provide written permission, instructions and a supply of unexpired medication.

Emergency Care Request: It is Piti Theatre Company practice to call parents and 911 in case of emergency. If you would like another procedure followed please indicate below.

In the event of an emergency requiring medical treatment, I give my permission for my child(ren)to be treated at Baystate Franklin Medical Center.

YesNoOther

Name of Child's Physician to be contacted if possible

Physician phone

Name of Friend to be contacted if parent is not reachable:

Phone

Photo Release: I give my permission for Piti Theatre Company to use photos or video clips of my child in any press, poster, Piti website, or other promotional materials developed to support this production/class/camp.

YesNo

I would like to receive email from Piti Theatre about events, workshops, etc.

YesNo

Participation Release: I give permission for my child(ren) to participate in Piti Theatre programming and understand that all physical exercise involves some risks. I assume all risks associated with participation in this program, including, but not limited to: falls, contact with other participants, the effects of weather, traffic, and other reasonable risk conditions associated with the program. All such risks to my child are known and appreciated by me. I understand this informed consent form and agree to its conditions on behalf of my child. Further, I authorize the Piti Theatre Company faculty person(s) to provide emergency medical treatment of any injury or illness my child may experience including treatment by qualified medical personnel if they consider treatment necessary. This authorization is granted only if I cannot be reached and a reasonable effort has been made to do so, or in a life-threatening situation. (Please note: Only one parent need sign, signature and date must be updated with each class/production)

Name

First NameLast Name

Signature

Date

Name

First NameLast Name

Signature

Date

PITI THEATRE YOUTH TROUPE PARENT/CHILD CONTRACT

EXPECTATIONS FOR YOUTH TROUPE ACTORS:

I wish to take part as an actor in this Piti Theatre production and I agree to:

1. Attend all scheduled rehearsals. dress rehearsals, and assigned performances, except for those for which my absence has been excused in advance by Piti Directors, or those that must be missed because of the actor's illness or other family emergency (in which case a parent or guardian will call the Directors to let them know).

2. Attend all scheduled "tech" dress rehearsals and performances

3. Be helpful to my fellow actors

5. Memorize my role(s)

6. Carefully protect all Piti costume pieces and props that I use

7. Not bring phones/games/i-watches, etc. to rehearsals or performances to minimize distractions while we are rehearsing

8. Conduct myself with courtesy toward fellow participants, directors, volunteers, and any off-site performance hosts;

I have read (or have had explained to me) and understand and agree to the above.

Actor Name

NOTE ON PARENT/GUARDIAN INVOLVEMENT:

Youth Troupe's success partly depends on parent involvement and help in completing key tasks - such as help with costumes, publicity, etc. as their schedule and interest allows. Parents will be asked to help with these areas.

Agreement of Parent/Guardian of Youth Troupe Actor

My child (or ward) is applying to act in this Piti Theatre production; I, therefore:

1. Agree that my actor will attend all scheduled rehearsals and performances to which they are assigned, unless an absence is excused in advance;

2. Acknowledge that Piti Theatre is a private membership organization, and that all decisions about participation and casting are at the discretion of the Directors;

3. Agree to encourage my actor to rehearse songs and scenes at home in a timely manner

4. Acknowledge that my actor could be withdrawn from one scheduled performance (or more) if he/she misses too many scheduled rehearsals

5. Acknowledge that Piti can make no refunds after this program is developed and cast. For the Fall - Winter 2024 - 2025 production, payment or payment arrangements are due by October 29th (second rehearsal). Checks can be made to "Piti Theatre Company, Inc."

Parent/Guardian Name