THE CONFIDENT ACTOR – COURSE REGISTRATION

THE CONFIDENT ACTOR – COURSE REGISTRATION

Thank you for your interest in The Confident Actor Workshop: This Confidence-Building Acting Workshop was created for Young Performers (Ages 14–17).

Please complete this application form in full. A parent or guardian must complete the required sections for participants under 18 years old.

A new form must be filled out for each student.
Workshop Options
One-Day Intensive (For Parents/Guardians) April 25th 10:00 AM – 4:00 PM Dallas, TX More details coming soonSchool/Organization – Interested in Workshops (Inquiry Only)

PARENT / GUARDIAN INFORMATION
Child’s Pronouns*
Child’s First & Last Name*
Child's Age
Note: Must be between ages 14–17 to participate
Child's Email Address*
example@example.com
Child's Phone Number*
T-Shirt Size:*
Parent/Guardian Full Name*
Parent/Guardian Email Address*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
ParentLegal GuardianOther
PARENTAL CONSENT & LIABILITY WAIVER

The Confident Actor – Acting Workshop

I, the undersigned parent or legal guardian of the above-named student, give permission for my child to participate in The Confident Actor workshop facilitated by Denise Lee.

In-Person Participation

I understand that:
- I am responsible for dropping off and picking up my child on time for all in-person sessions.
- The Confident Actor, its facilitator, and any affiliated venues are not responsible for supervision outside of scheduled workshop hours.
- I assume all risks associated with my child’s participation in in-person activities and release The Confident Actor from any liability for injury, loss, or damage except in cases of gross negligence.
Virtual Participation

If the workshop is conducted virtually, I understand that:
- My child will participate from a location outside the facilitator’s control.
- The Confident Actor is not responsible for incidents, injuries, or disruptions that occur in the child’s home or virtual environment.
- I am responsible for ensuring a safe, appropriate space and adequate supervision as needed.
General Release

I acknowledge that acting exercises may involve emotional expression and personal reflection. I consent to my child’s participation and understand that the workshop is educational and confidence-based, not therapeutic.

I release and hold harmless The Confident Actor and Denise Lee (DBA Denise Lee Onstage) from any claims arising from participation in this program.
I have read and agree to the Terms, Waiver, and Parental Consent Agreement below.
School / Organization Inquiry
Full Name*
Email*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Organization/School Name*
YesNo
Single WorkshopMulti-Session Workshop
Estimated Number of Students
Student Age Range
Additional Emergency Contact
Emergency Contact Name*
Emergency Contact Number*
Multi-session workshops are not currently open for public registration. Submit this form to receive more information.
ACTING EXPERIENCE & GOALS
Beginner (little to no experience)Some experience (classes, school productions)Experienced (theatre, auditions, coaching)Other
Please briefly describe the student’s experience.
(If applicable)
Confidence on stageAudition skillsManaging nerves & self-doubtScene & monologue workPersonal growth beyond actingOther
Any specific challenges the student faces?
(Example: stage fright, self-confidence, feedback anxiety)
HEALTH & ACCESSIBILITY
Does the participant have any allergies, medical conditions, or accessibilityneeds we should be aware of?
YesNo
If yes, please describe accommodations needed.
ADDITIONAL INFORMATION
School / Theatre ProgramSocial MediaFriend / Word of MouthWebsiteOther
PHOTO / MEDIA RELEASE
I grant permission for Denise Lee Onstage to use photos and/or video for educational and promotional purposes.I do not grant permission.
PAYMENT CONFIRMATION

Please note that registration is not complete until payment has been received or successfully processed online.
Payment EnclosedPayment Submitted Online
Parent/Guardian Name:*

Clear
Signature (Typed Name):
Date: *

MonthDayYear
Each child must be registered separately. If registering multiple children, please submit this form again after completing payment.
Yes → Please submit a new formNo
Thank you for starting your registration! After submitting this form, you will be redirected to complete payment. Registration is not complete until payment is received.
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THE CONFIDENT ACTOR – COURSE REGISTRATION

Workshop Options

PARENT / GUARDIAN INFORMATION

School / Organization Inquiry

Additional Emergency Contact

ACTING EXPERIENCE & GOALS

HEALTH & ACCESSIBILITY

ADDITIONAL INFORMATION

PHOTO / MEDIA RELEASE

PAYMENT CONFIRMATION