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Stratford Trip - Student Registration
Name: *
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Gender Identity: *
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Email: *
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Emergency Contact Name: *
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Emergency Contact Number: *
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Do you have any medical conditions or allergies that we should be aware of? If so, please list clearly. *
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Name of Roommate(s): *
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Room/Bed Preference *
Student Waiver Form
I, on behalf of my child, HEREBY WAIVE AND RELEASE, indemnify, hold harmless and forever discharge HEIDI STEPANEK and THE ACADEMY FOR MUSICAL THEATRE and its teachers, employees, and volunteers of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I or CHILD ever had or may have, arising from or in any way related to CHILD’S participation in any of the functions or activities conducted through the field trip to Stratford, ON, from May 27-29, 2019. CHILD has no illnesses, allergies or disabilities that may require special attention, except as described earlier in this registration form. I authorize Heidi Stepanek and other agents of The Academy for Musical Theatre to disclose these conditions to a physician or other medical professional in the event said CHILD should require emergency medical care. I am aware of the usual risks and dangers inherent in participation in all of the activities associated with this trip, and of the possibility of personal injury, death, property damage or loss resulting from the activities. CHILD and I understand that he/she must behave in an appropriate and safe manner throughout the duration of the trip. I will be responsible for any costs caused by CHILD’S failure to abide by an appropriate code of conduct, including any loss or damage of property, or costs to send CHILD home. Accidents can be the result of the nature of the activity and can occur with or without any fault on either the part of the student, The Academy for Musical Theatre or its employees or agents, or the facility where the activity is taking place. By allowing your son/daughter to participate in this trip, you are accepting the risk of an accident occurring, and agree that this field trip is suitable for CHILD. CHILD is in satisfactory physical and mental condition to safely participate in the activities listed in the trip itinerary. I am 19 years of age or more and have read and understand the terms of this consent and waiver, and understand that it is binding upon me, my heirs, executors and administrators.

I understand that there are no refunds available, and that if my child is unable to attend for some reason their trip may be transferred to another person at my discretion.

I agree to the above waiver *
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Adult Name: *
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Completing registration:
There are two steps remaining to complete your child's registration. Please be sure to do both in order to save your spot for our Stratford trip:

1. First, go to PayPal and make your payment: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=LYN3Y6AKANREW

2. Then, click the "Submit" button at the bottom of this form.

We're so glad you're going to be a part of our twentieth year!!

Please note that registration is not complete until payment is received.
Thank you for joining us on our 20th Stratford Tour!!!
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