Person to be contacted in case of emergency (other than parent)
If no contact is made, I give permission for my child to be transported to the nearest medical facility
Does your child have any medical conditions, past injuries, or allergies that we should be aware of?
Siblings who will also be attending Blue Pearl Theatrics Weekend Fall Performing Arts Program:
Name of person/s who can pick up your child:
How did you hear about Blue Pearl Theatrics Children's Theater Program?
Please describe your child's acting/dancing/performance experience:
PAYMENT METHOD:
(Check, money order, or C.C. must be in U.S. funds made payable to Blue Pearl Theatrics.)
Please check appropriate option below:
Enclosed is my payment:
Payment Information