Monologue & Improv Elementary Camp Registration

Student Information

Parent/Guardian Information

Emergency Information

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by GBT during the selected camp. In exchange for the acceptance of said child’s candidacy by  GBT, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless GBT. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against  GBT. including all teachers and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

Medical Release and Authorization

As Parent and/or Guardian of the named student(s), I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named student(s). In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the  GBT and its affiliates including directors, tseachers, and event staff to provide the needed emergency treatment prior to the student(s) admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child/children, in my absence.

Photo/Media Release Statement

As Parent and/or Guardian of the named student(s), I hereby authorize the likeness in photographs, videos, and other media in any and all of its publications, including but not limited to social media, print materials, video productions, and its website, without payment or any other consideration. I further consent to the use of the student’s name and accompanying details, if applicable, in connection with the above media.

I acknowledge that I may request this release to be voided at any time by sending an email to info@mygbt.org with the student’s name(s) included.

Camp Policy

USE EMAIL you WILL CHECK. Correspondence, updates and info sent through EMAIL. Please let us know if your child has any medical or behavioral conditions. We will expect your child to participate in ALL activities. Picking and choosing activities they want to participate in can become disruptive and problematic for the morale and confidence of the other campers.

DISCIPLINE POLICY & EXPECTATIONS:

1.Sitting inappropriately on theatre seats (Bouncing, jumping, sitting on unfolded seats)

2.Running anywhere in the theatre

3. Disruption of instructors when instructing (talking, playing, ignoring, not following direction)

4. Disruption when fellow actors are acting (talking, playing, making noises)

5. Not following directions

6. No wandering off or going backstage without an instructor

7. Campers are responsible for their booklets, scripts, and items at the theatre

8.We all eat as a group, NO EATING at non-designating meal times

9. No destruction of Theatre property; 1st Warning: Child we be verbally asked to cease inappropriate behavior 2nd Warning: Parent will be called 3rd Warning: Parent will be asked to pick up child early 4th Warning: Parent will be asked to come to camp with child as a chaperone 5th Warning: Child will be dismissed from camp with NO refund.

I agree to GBT policies and agree to release, discharge and hold harmless the Gaslight Baker Theatre and its officers, directors or agents, of and from any claims, demands or liability of damage arising from the participation of my child in any Gaslight Baker Theatre programs.

CONFIRMATION

BY ACKNOWLEDGING AND SIGNING BELOW, I UNDERSTAND AND AGREE TO THE ABOVE POLICIES AND AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.