House Theatre Parent Team Member

House Parent Team Member Application

Complete the form below to register for House Theatre participation.
Program and Contact Information

Please indicate the program you are applying for.
Indicate the area you would like to assist with.

Teacher AssistantClassroom HelperSafety TeamWardrobe/MakeupCleaning Crew
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
E-mail*
example@example.com
Phone Number:*

Area CodePhone Number
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Experience and References
Please list any applicable experience (note: experience preferred but not mandatory).*
Do you have previous experience through House Theatre Inc.?*

YesNo
Briefly describe your motivation for volunteering with House. What do you hope to contribute and what do you hope to gain? *
Please detail your organizational skillsets and approach. If possible, please provide an example. *
Reference One Name*

First NameLast Name
Reference One Email*
example@example.com
Reference One Phone Number*

Area CodePhone Number
Reference Two Name*

First NameLast Name
Reference Two Email*
example@example.com
Reference Two Phone Number

Area CodePhone Number
Membership Rules
Membership is available to persons who have read, understood, and agree to demonstrate respect towards House Theatre's Code of Conduct and Statement of Faith.
Please Check The Following

I have read, understood, and agree to demonstrate respect towards House Theatre's Code of Conduct and Statement of Faith.
Medical Waiver

Applicants must complete a medical waiver to participate in House.
Emergency Contact Name 1*

First NameLast Name
Relation to Participant*
Phone Number*

Area CodePhone Number
Emergency Contact Name 2*

First NameLast Name
Relation to Participant*
Phone Number*

Area CodePhone Number
Insurance Card Information
Indicate any medical history deemed necessary. Note that the attached waiver is provided for transparency and clarification.
Are there any allergies we should be made aware of?
Date of Form Completion

MonthDayYear
Date
Signature

Clear
Once you submit your application, and we have contacted your references, we will contact you to complete your membership application. Thank you!
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House Parent Team Member Application

Program and Contact Information

Experience and References

Membership Rules

Medical Waiver