Opening Act Student Theatre Registration Form

Opening Act Student Theatre Registration Form

Please fill out this form to register.
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Please list your child's preferred snack

Please fill in sizes for costuming purposes.

School Grade as of September
Parent/Guardian Full Name

First NameLast Name
Relationship to student
Contact Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Emergency Contact Name

First NameLast Name
Relationship to student
Emergency Contact Phone Number
Format: (000) 000-0000.
Does the student have any allergies or health issues that we should be aware of? What is the preferred treatment?
Medical Release: I give consent for QYU staff and/or volunteers to give first aid and/or to seek emergency medical care for my child(ren) if needed. I understand that QYU staff or volunteers will contact me as soon as possible in cases of medical or other emergencies.
Does the student have any behavioural or emotional issues we should be aware of?
Please check the following boxes if you give consent to Quinte Youth Unlimited staff to post photos of your children for promotional and informational purposes on:
Please check the following if you give permission for Quinte Youth Unlimited to share this contact information in a Team Directory.
Please indicate the payment option that you will be using.
By submitting this form you are providing consent to Quinte Youth Unlimited to use the personal information provided to deliver its programs and services. If you have any questions about our collection, use, and disclosure of personal information, please refer to our Privacy Policy.
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