After School Actors Registration Form

Name and age of student*

First NameLast NameAge

Name of Parent/Guardian*

Parent/Guardian Cell Number*

Area CodePhone Number

Email*

example@example.com

Student Email (Optional)

example@example.com

Emergency Contact*

Phone Number*

Mailing Address (optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Rehearsals Mondays, Wednesdays, and Thursdays 3:30-5:30pm

March 23rd (Parent meeting), 25th,26th, 30th

April 1st, 2nd, 6th, 8th, 9th, 13th, 15th, 16th, 20th, 22nd, 23rd, 27th, 29th, 30th

May 1st, 4th, 6th, 7th

Shows

May 8th & 9th

*Attendance is required on dates highlighted in red .

Are you able to attend the parent meeting on March 23rd?*

YesNo.

If you miss the parent meeting you may miss key information. It is your responsibilty to read the meeting notes and follow up with the director.

Are you going to miss any rehearsal dates? Please let us know about any and all conflicts. We will be using this info to plan out our rehearsal schedule. *

Please tell us more about your student actor. Do they have any special needs that we should accommodate? Such as allergies, reading struggles, or sensory processing disorders. Do they require any aid tools (ie. headphones and fidget toys). *

How did you here about us?

A friendFacebookInstagramOther

Would you like receive e-mails about upcoming classes and shows?

YesNo

WAIVER OF LIABILITY/RELEASE – PLEASE READ CAREFULLY In consideration of myself and/or my child being allowed to participate in From Page to Stage Productions-sponsored activities, I assume any and all risks, including risk of injury or death, associated with my or my child’s use of said facilities and/or participation in said activities. I further agree on behalf of myself, my heirs, executors, assigns, and personal representatives, to waive and release any and all rights and claims for damages, including attorney fees, I now, or may hereafter have, whether known or unknown, against From Page to Stage Productions (FPTSP) and its officials, employees, and agents for any injuries suffered by me or my child in connection with participation in FPTSP-sponsored activities. I acknowledge that I have carefully read this Waiver of Liability and fully understand that I am waiving any right that I may have to bring a legal action or to assert a claim against the From Page to Stage Productions.

PHOTO/VIDEO RELEASE: I give my permission to have photos and/or video and audio recordings taken of me or my child by From Page to Stage Productions (FPTSP) or its agents for publicity purposes during FPTSP activities even though we will not receive compensation of any kind for appearing in such photos or video recordings. If you wish to waive the photo release, please contact the main office at 253-350-8344 or theater@pagetostagepro.com. I have read, understood, and voluntarily accepted the conditions of the Waiver of Liability/Release and the Photo Release printed above on behalf of myself and/or my child:

I understand and agree.

Payment Options*

Pay Now OnlineDiscuss Scholarship OptionsPaid for a group on Separate From

If you are registering more then one student please fill out a regitration form for each child. Pay the full amount of tuition for all your students on the first form and skip payment on on the subsequent forms.

Name of Student whose Form was used for a group payment

To discuss available Scholarship options please email us at theater@pagetostagepro.com.

Student Registration$200.00

Standard Student Registration Fee

Number of Students You are Registering

Subtotal $0.00Tax $0.00Total $0.00

Parent/Guardian Signature*

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

The Masked Musketeer