DRAMATIC PLAY REGISTRATION FORM & WAIVER

Wednesdays 5:00-5:30pm | Ages 5-8 |

Class Dates: Feb 12, 19, 26; Mar 5, 19, 26 (no class March 12th - March Break); Apr 2, 9

To register your child for Dramatic Play, please fill out this form, which acts as your waiver as well. Globus Theatre has a No Refunds, No Exchange Policy. If you need help deciding if this workshop is right for you, please call 705-738-2037 or email info@globustheatre.com.

After submitting this form, you will then be transferred to our TixHub site to make your purchase. You will choose your class in the drop down menu and will then be taken through the steps to complete your purchase. Thank you!

If you have any issues with the payment site, please email us at info@globustheatre.com.

Name of Participant

First Name

Last Name

Name of Parent/Guardian if participant is under 18

First Name

Last Name

Age of Participant

Participant's Birthdate

YYYY

What is the participant's prior experience in the performing arts, if any?

Please confirm you are able to meet the faculty on February 3rd

Contact Information

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

The best way to get in touch with me is...

Emergency Contacts

1. Emergency Contact Name

Emergency Contact Phone Number

(###)

###

####

Relationship to participant

2. Emergency Contact Name (optional)

Emergency Contact Phone Number (optional)

(###)

###

####

Relationship to participant (optional)

Is there anything else you'd like us to know about you/your child?

Please provide any pertinent information below (i.e. health concerns, allergies, preferred pronouns etc.).

Pick Up List

Please provide names and phone numbers of anyone who has your permission to pick up the participant at the end of the workshop.

Waiver Agreement

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

I am aware and familiar with the class that I have or my child has enrolled in. 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/my child, 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/my child. 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 my child for educational or marketing purposes.

I, the parent/guardian, understand and agree with all the above terms.