Classes Registration Form
Caregiver Name
*
First Name
Last Name
Caregiver Email
*
example@example.com
Caregiver Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Student 1- Name
*
First Name
Last Name
Student 1 - Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student 1 - Grade Level
*
What program(s) are you registering Student 1 for?
*
Fall 2026: Ready, Set, Improv (Grades 6-8)
Fall 2026: Commercial Creators (Grades 3 - 5)
Does this student have any allergies or other health concerns that our education staff should be aware of?
*
Yes (please list below)
No
If yes, please list them below:
Does this student have any communication, mobility, or other needs that you would like us to know about?
*
Yes (please list below)
No
If yes, please list them below:
I allow Portland Stage to use my child's photo, video or audio:
*
Yes, can use in marketing
No, do not use in marketing
Anything else you would like for us to know about this student?
Student 2 - Name
First Name
Last Name
Student 2 -Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student 2 - Grade Level
What program(s) are you registering Student 2 for?
Ready, Set Improv (Grades 6-8)
Commercial Creators (Grades 3-5)
Does this student have any allergies or other health concerns that our education staff should be aware of?
Yes (please list below)
No
If yes, please list them below:
Does this student have any communication, mobility, or other needs that you would like us to know about?
Yes (please list below)
No
If yes, please list them below:
Anything else you would like for us to know about this student?
I allow Portland Stage to use my child's photo, video or audio:
Yes, can use in marketing
No, do not use in marketing
Release Information
I understand these activities may include certain risks including, but in no way limited to: (1) moderate & severe personal injury, (2) property damage, (3) disability, (4) death, & (5) sickness or disease including, without limitation, COVID-19. I specifically release Education, its owners, directors, employees, & volunteers from any claim of any kind arising from my student’s participation in the Education program.
Initial
*
Behavior Policy
We are committed to working with students, parents, and guardians to ensure everyone has a positive experience at Portland Stage. Each student is expected to engage with others in a safe and respectful manner to help everyone achieve the best possible experience. If our Teaching Artists or Staff have a concern regarding a camper’s behavior, our policy is: 1. Teachers/Staff will redirect the student to more appropriate behavior. 2. If inappropriate behavior continues, the student will be reminded of the camp expectations and behavior guidelines. Together, the student & teachers/staff will decide on action steps to correct the behavior. 3. If disruptive behavior continues and/or is affecting the safety or well-being of others, Education staff will contact the parents or guardians. 4. If inappropriate behavior continues, as a final action step, the student may be dismissed from camp. (Please note – Student fees are non-refundable if a student is sent home for disciplinary reasons). I have read and agree to the Behavioral Dismissal policy. If you have any questions, please contact education@portlandstage.org
Initial
*
Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
PLEASE NOTE: This registration is not complete until the payment is completed on the next window.
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