Actor's Quest November Workshop

DFT Actor's Quest Workshop

November 14

10a-2p

Ages 8-14

Class Fee: $40 per student or

$60 family rate (3 sibling limit)

Child's Name*

First NameLast Name

Child's age*

Child's school grade*

Child's Name

First NameLast Name

Child's age

Child's school grade

Child's Name

First NameLast Name

Child's age

Child's school grade

Is this child a returning Desert Foothills Theater student or actor?*

YesNo

Parent or Legal Guardian #1*

First NameLast Name

Relationship to Child*

Best Phone Number*

Area CodePhone Number

Parent/Guardian #1 Email Address*

Parent/Guardian #1 Second Email Address (if you have one)

Parent or Legal Guardian #2

First NameLast Name

Relationship to Child

Parent or Legal Guardian #2 Best Phone Number

Area CodePhone Number

Parent/Guardian #2 Email Address

Does your child require any special accommodations? If yes, please describe. If no, put N/A.*

Does your child have any medical, physical, emotional, or behavioral conditions which may affect his/her safety while in class? if yes, please describe. If no, put N/A.*

Would you like us to know anything else about your child? If yes, please describe. If no, put N/A.

DFT 2025

General Medical Release and Photo/Video Release

Desert Foothills Theater does not provide medical insurance for any participant in any program offered. I, the Parent or Guardian of this student as registered, a minor, do hereby authorize the directors and teachers of Desert Foothills Theater as agents to consent to medical emergency treatment. I hereby release Desert Foothills Theater and its Board of Directors from any and all claims from personal injuries.

As the parent and/or legal guardian of the student registered here, I hereby give permission for my student to be given emergency treatment as needed by members of Desert Foothills Theater (DFT). I give permission for the student to be transported by ambulance to an emergency center for treatment. In the event that I, my student’s listed emergency contact, or my preferred physician cannot be contacted, I consent to medical, surgical and hospital care treatment and procedures to be performed for my child by a licensed physician or hospital when deemed immediately necessary or advisable by a physician to safeguard my child’s health. I agree that I will not hold DFT or any member of its staff liable for damages, injuries or losses during the student’s participation with the DFT education programs.

I also consent that student’s photo or video may be taken and used for any purpose deemed necessary to promote Desert Foothills Theater's education program without compensation.

GENERAL MEDICAL RELEASE: I have read, understand, and agree with this document.*

Yes

GENERAL PUBLICITY RELEASE: I have read, understand, and agree with this document.*

YesNo

I have read and understand that there are no refunds or exchanges. All registrations are final.*

Yes

Educational Workshop Fee*

DFT Actor's Quest November Workshop Family Rate$60.00

DFT Actor's Quest November Workshop$40.00

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 verify that you are human*

Student's Information

Parent/Guardian Information

Special Accommodations