YTN 2024-2025 Season Crew Application

Section 2: Medical information

(Part 2 of 4)
Person(s) to whom student may be released other than Parent/Guardian. Please list their name and phone number. To add more, click the plus sign.
YesNo
Essential medication of which we should be aware:*
Pertinent medical/neurological/psychological conditions of which we should be aware:*
Please share information you feel would be helpful in the context of your child's participation at YTN in order for us to best serve them. This information will be kept confidential between the Director and the Stage Manager. Please also list any allergies your child has.
Primary Doctor*
Hospital*

Section 3: Consent/Waiver

(Part 4 of 4)
It is the policy of Youth Theatre Northwest (YTN) to provide a safe and healthy environment for all students. Some of our activities involve group movement, stage sets and props. YTN takes measures to minimize potential hazards. However, these activities carry some unavoidable risk of injury or exposure to common communicable diseases. I have read the above statement and I give my permission for my child to participate in activities at YTN. I authorize YTN to act on behalf of my child in the event of an emergency and if my designated alternate or I cannot be reached, I wave and release YTN from any liability connected with illness or injury, which may arise in connection with their participation in YTN activities.*

I agree
YES, YTN can use the image for my child in promotional materialNO, YTN may not use the image of my child in promotional material

YOU'RE DONE!