Name of Participant *

First Name

Last Name

What is your availability for rehearsals? *

Please pick all that apply

Monday mornings

Monday afternoons

Monday evenings

Tuesday mornings

Tuesday afternoons

Tuesday evenings

Wednesday mornings

Wednesday afternoons

Wednesday evenings

Thursday mornings

Thursday afternoons

Thursday evening

Friday mornings

Friday afternoons

Friday evenings

Saturday mornings

Saturday afternoons

Saturday evenings

Sunday mornings

Sunday afternoons

Sunday evenings

Are you available for shows from May 29th to June 7th? *

Yes

No

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone Number *

(###)

###

####

Please read the terms below and check the box to agree. *

I am aware and familiar with what I have signed up for. I acknowledge that there is a risk of injury when receiving instruction and at the times when I am without instruction. In consideration of the facility and location provided to me, I forever release, discharge, and hold harmless Globus Theatre and any of its employees, representatives, or members from all liability or claim. Medical Emergency: I consent for any employee or representative of Globus Theatre to seek reasonable medical treatment, emergency or otherwise, at any time for me. I agree to be liable for the cost of such treatment. Additional Waiver: I hereby grant Globus Theatre permission to lawfully photograph and/or videotape myself for educational or marketing purposes.

I understand and agree with all the above terms.