Family Fun Night Sign-Up

Guardian Name*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.

How many children are you signing up? (This event is for potty trained pre-k through 8th grade students)*

Child #1 Name

First NameLast Name

Child #1 Age

Child #2 Name

First NameLast Name

Child #2 Age

Child #3 Name

First NameLast Name

Child #3 Age

Child #4 Name

First NameLast Name

Child #4 Age

Child #5 Name

First NameLast Name

Child #5 Age

List any additional Names and Ages Here

Liability Waiver

1. Acknowledgment and Assumption of Risk
I, the undersigned parent or legal guardian, acknowledge that I am voluntarily allowing my child to participate in the “Family Fun Night” event organized by Stage Center. I understand that while reasonable precautions will be taken to ensure the safety and well-being of all participants, participation involves certain inherent risks, including but not limited to accidents, injuries, or illness.

I voluntarily assume all risks associated with my child’s participation in this event.

2. Medical Authorization
In the event of an emergency, I authorize the staff, volunteers, or representatives of Stage Center to seek and obtain medical care, including transportation and treatment by qualified medical personnel, for my child. I agree to be fully responsible for any expenses incurred as a result of such medical treatment.

Please list any allergies, medical conditions, or special needs:

3. Liability Waiver and Release
In consideration for my child’s participation in the event, I hereby release, indemnify, and hold harmless Stage Center, its employees, volunteers, representatives, and affiliates from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, or injury (including death) that may be sustained by my child or property while participating in or traveling to/from the event.

4. Behavior and Supervision
I understand that my child must abide by the rules and instructions of event staff. Stage Center reserves the right to contact me for immediate pickup if my child’s behavior is deemed unsafe or inappropriate.

5. Pickup
Failure to pickup my child within 10 minutes of the conclusion of Family Fun Night (10pm) will result in a fee of $1.00 per minute past such 10 minute period, and I agree to pay said fee upon pick up. Failure to pick up on time may result in the inability to participate in another Family Fun Night.

Emergency Contact (Other than the guardian listed above)*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

Payment

Family Fun Night is a fundraiser to help support Stage Center and our students going to Disney's Magic Fest in June. Thank you for supporting us!

Family Fun Night (1st child) - $30

Family Fun Night (Each additional child) - $15

Additional donations are welcome to support Stage Center and our student's going to Magic Fest.

Payment Amount*

USDDescription

Payment Methods

Credit Card

Apple Pay

Google Pay