2024-2025 Stewarts Creek Feeder Wide Musical Registration Form and Contract

2025-2026 Stewarts Creek High School

Feeder-Wide Musical Registration Form and Contract
Note: This form is to be filled out by a parent/guardian.

Please make all signatures legible.
The signatures on these forms will be printed on medical forms and used by medical professionals in the unlikely event of an emergency.
Student Name*

First NameFull Middle NameLast Name
Do you ACCEPT or REFUSE your role in Elf, Jr (Note, if you choose "Refuse" your role will be given to another student. If you choose "Accept" you are committing to the role, including the dates outlined in the Calendar found on CreekFineArts.com)?

ACCEPTREFUSE
Grade Level (2025-2026)*
School Currently Attending*
Other School
Height (in inches)*
Date of Birth*

MonthDayYear
Date
T-Shirt Size *
Race/Ethnicity (for grant purposes)*

American Indian/Alaska NativeAsianBlack or African AmericanHispanic or LatinxMiddle Eastern or North AfricanNative Hawaiian or Pacific IslanderWhiteI prefer not to sayOther
What language is primarily spoken at the student's home (for grant purposes)?*

ArabicBurmeseEnglishSpanishI prefer not to sayOther
Student Mailing Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student RCS Email Address*

Confirmation EmailIf unknown, put student's personal email or parent email.
Student Personal Email Address*

Confirmation EmailIf unknown, put student's RCS email or parent email.
Student Cell Phone Number (if none, use parent cell)*
Cell Phone Number is:*

Student Cell Phone NumberParent Cell Phone Number
I understand that the number listed in the Student Cell field might be loaded into Remind for purposes of communicating official business/activities of the Stewarts Creek High School Fine Arts Academy. I am also aware that I may opt of this anytime by texting @LEAVE to the number you are receiving messages from.*

I Understand
(Primary) Parent/Guardian 1 Name*

First NameLast Name
(Primary) Parent/Guardian 1 Relation to Student*
(Primary) Parent/Guardian 1 Address is:*

Same as Student'sDifferent than Student's
Primary Parent/Guardian 1 Address*

Street Address

Street Address Line 2

CityState

Zip Code
Primary Parent/Guardian 1 Email*

Confirmation Emailexample@example.com
Primary Parent/Guardian 1 Cell Phone Number*
I understand that the number listed in the Primary Parent/Guardian 1 Cell field mightbe loaded into Remind for purposes of communicating official business/activities of the Stewarts Creek High School Fine Arts Academy. I am also aware that I may opt of this anytime by texting @LEAVE to the number you are receiving messages from.*

I understand
Would you be able to serve as a parent volunteer as needed during the rehearal/performance calendar of this show?*

YesNo
Would you like register another Parent/Guardian?

YesNo
(Secondary) Parent/Guardian 2 Name

First NameLast Name
(Secondary) Parent/Guardian 2 Relation to Student
(Secondary)Parent/Guardian 2 Address is:

Same as Student'sDifferent than Student's
(Secondary) Parent/Guardian 2 Address

Street Address

Street Address Line 2

CityState

Zip Code
(Secondary) Parent/Guardian 2 Email

Confirmation Emailexample@example.com
Would you be able to serve as a parent volunteer as needed during the rehearsal/performance calendar of this show?

YesNo
(Secondary) Parent/Guardian 2 Cell
I understand that the number listed in the (Secondary) Parent/Guardian 2 Cell field might be loaded into Remind for purposes of communicating official business/activities of the Stewarts Creek High School Choirs. I am also aware that I may opt of this anytime by texting @LEAVE to the number you are receiving messages from.

I Understand
Consent and Agreement

By signing below, I, the parent/guardian of {studentName} give my permission for {studentName} to fully participate in the Stewarts Creek High School feeder-wide performance of Elf, Jr in the Fall semester of 2025 in the role assigned on the Cast List.
- We have or will read all of the Parent Documents handed out on the Parent/Cast meeting on September 2, 2025 and available at www.CreekFineArts.com.
- We have or will read the Rehearsal/Performance calendar handed out at the Parent/Cast meeting on September 2, 2025 and available at www.CreekFineArts.com.
- We agree that at least one parent per family must sign up for at least one Supervision shift (during the last week of rehearsal and/or performances) and that Parent Sign-Ups are forthcoming.
- We agree to read all emails sent from DugginL@rcschools.net, FannD@rcschools.net, schsproductionteam@gmail.com and/or RussellB@rcschools.net.
Parent Signature (please sign legibly)*

Clear
2025-2026 Stewarts Creek Feeder-Wide Musical

Medical Information and Release Form
Your child's Primary Physician Name*
Enter physician name or N/A
Primary Physician Phone*
Emergency Contact Name if Parent(s)/Guardian(s) Cannot be Reached*

First NameLast Name
Emergency Contact Cell Phone Number*
Emergency Contact Relation to Student*
Vision and Audiology (Check All That Apply)

GlassesContactsHearing Aid
Has your child ever received a Tetanus Shot?*

YesNo
Do you know the date of your child's last Tetanus Shot?*

YesNo
Date of student's last tetanus shot:*
MM-DD-YYYY
Does your child carry / require an EPI Pen?*
Does child carry / require an Asthma Inhaler?*
Does child have a nut allergy?*
Please list your child's known food or medication allergies, or enter "N/A" if none.*
Please list your child's known medical conditions or enter "N/A" if none.*
Please list your child's prescription/over-the-counter medications being taken or enter "N/A" if none.*
Health Insurance Company Name*
Enter insurance company or N/A
Insurance Policy Number*
Enter insurance policy # or N/A
Consent and Agreement

In the event that {studentName} is presented for, or requires medical treatment or surgery or any other form of medical care or aid, I, {primaryParentguardian26}, as the parent/legal guardian of the above named student, do hereby authorize the Directors/Chaperones standing in loco parentis to be consulted with, and consent to, any medical treatment or care deemed necessary by any doctor, nurse or other medical personnel. I also guarantee payment of all charges incurred for medical treatment such as, but not limited to physician, hospital, x-ray, lab, drugs, and EMS. (For emergency use only. Every effort will be made to contact parent/guardian prior to treatment). I agree to indemnify and hold harmless the Fine Arts teachers, staff and chaperones of Stewarts Creek High School and Rutherford County Schools, its agents and employees for any and all claims, demands, actions, rights of actions and/or judgments by or on behalf of the above named student arising from or on account of said procedures and/or treatment(s) rendered in good faith.

By entering my name below, I {primaryParentguardian26}, attest that I am a parent or legal guardian of {studentName} and that the medical information provided on this form is accurate. I hereby consent and agree,
Parent/Guardian Signature for Medical Release Form*

First NameLast Name
Signature (Please sign legibly)*

Clear
2025-2026 Stewarts Creek Feeder-Wide Musical

School Activity Policy
I, {primaryParentguardian26}, parent of {studentName}, understand that participation in the Stewarts Creek Feeder-Wide Musical is an enrichment activity, and that activities at the school that I attend should be the first priority of my student.

As such, by accepting this role we agree to be a part of the choir and/or theater/drama activities at the school my child attends (if choir/theater are offered at my school and for my grade level). If choir and/or theater have not yet begun, I agree to enroll in the choir and/or theater programs at my school once choir and/or theater programs begin.
Parent/Guardian Signature for School Activity Policy*

First NameLast Name
Signature (Please sign legibly)*

Clear
2025-2026 Stewarts Creek Feeder-Wide Musical

Arrival and Pick-Up Policy
By signing below, I, {primaryParentguardian26}, parent of {studentName}, understand that {studentName} will ARRIVE at SCHS for rehearsals/performances according to the following conditions:
- If my child attends Stewarts Creek Elementary, I understand my child will be dismissed to the gym, meet and walk over with an SCHS theater or choir faculty member, then will sit in either the SCHS Theater or Choir room until rehearsal begins. I understand that my child should have an umbrella and possibly a snack/water for rehearsal days.
- If my child attends Stewarts Creek Middle, I understand that my child will walk from SCMS to SCHS at dismissal, walk into the front of the school, then walk to the SCHS Theater/Choir room until rehearsal begins. I understand that my child should have an umbrella and possibly and snack/water for rehearsal days.
- If my child attends Browns Chapel Elementary, Poplar Hill Elementary, Rock Springs Elementary Rock Springs Middle, or Thurman Francis Arts Academy, that I must provide transporation to SCHS. I understand that
  - We should not arrive on campus before 3:45pm because of traffic;
  - I understand we should park on the north/gym side of campus and enter through the glass door near the choir room (about 100 feet to the right of the main gym doors).
  - I understand that a parent must walk students into the school.
When PICKING UP my child, I understand:
- That parents/guardians of Elementary School students should create a car-rider line on the north/gym side of SCHS per the traffic pattern posted on CreekFineArts.com;
- That parents of Middle School and High School students should park in a parking lot on the north/gym side and wait for students to come out to their car.
Finally, out of respect for the adults volunteering to make this experience possible, I agree to pick up my student on time. I understand and agree to abide by the "late pickup" policy:

"Students picked up more than 20 minutes the first time will be placed on a probationary status. Students picked up more than 20 minutes late the second time will be removed from all future rehearsals and performances"
Parent/Guardian Signature for Arrival/Pickup Policies*

First NameLast Name
Signature (Please sign legibly)*

Clear
Pickup/Dropoff Policy Authorized, this date:*

MonthDayYear
Date
Should be Empty:

2025-2026 Stewarts Creek High School

2025-2026 Stewarts Creek Feeder-Wide Musical

2025-2026 Stewarts Creek Feeder-Wide Musical

2025-2026 Stewarts Creek Feeder-Wide Musical