Model Boot Camp Registration Form

Model Boot Camp Registration Form

Please fill in the form below. One person per form.
Full Name*

First NameLast Name
Age:*
Sex:*

MaleFemale
Parent (If Minor)
Parents Name
Phone Number*

Area CodePhone Number
E-mail*
Height (If Model):
Emergency Contact*

First NameLast Name
Emergency Contact Phone*

Area CodePhone Number
Billing Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Referred By:*

FacebookInstagramWebsiteEmailAmbiance StaffFriendOther
If referred by a friend or Ambiance Staff please list name:
Modeling Boot Camp

Location: Element Chattanooga East 2312 Center Street Chattanooga, TN 37421 (Meeting Room A) Cost of Modeling Boot Camp is $395. Saturday & Sunday, November 1st-November 2nd 2025 from 10:00 am - 2:00 pm EST both days. *

Model Bootcamp (Non-refundable)$395.00

Non-Refundable payment of $395 to hold your spot-due in full prior to the first day of bootcamp.

Total $0.00

Credit Card

Signature*

Clear
Release Agreement: As participant or parent / guardian of the above participant, I give my permission for myself or my child (if under 18) to participate in the acting and/or modeling workshop. I agree to indemnify and hold harmless Ambiance Models & Talent, Inc., its sponsors, instructors and employees against any loss, damage, injury or other conditions arising out of myself or my child’s participation. I understand that all registration fees are non-refundable. Also, in consideration of the potential for additional publicity, I hereby authorize use of my photos, video or television for future use and advertising.
By clicking on "yes" and submitting my registration I am agreeing to the following: I have read and understand the form in its entirety. I am signing this form electronically. Also by clicking "yes" I am stating that I am the person registering, and I give permission for my credit card entered on this form to be charged.*

Yes
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