Primary Parent/Guardian Name *

Primary Parent/Guardian Home Address *

Primary Parent/Guardian Cell Phone *

Primary Parent/Guardian Work Phone & Place of Employment *

Secondary Parent/Guardian Name

Secondary Parent/Guardian Home Address

Secondary Parent/Guardian Cell Phone

Secondary Parent/Guardian Work Phone & Place of Employment

Is there someone other than the primary or secondary parent/guardian who supervising the student during class time? If so, please provide their name, relationship and phone numbers below:

Alternate Emergency Contact Name, Relationship & Cell Phone *

Child's Name *

Child's Age as of September 14, 2020 (Please submit this form a second time for a sibling.)

Child's School & Grade Level for Spring 2021 *

Any Student Allergies? / Medical, Emotional or Social Considerations?

If new, please list any performing arts experience the student has, or other relevant information you'd like to share.

Please list any known scheduling conflicts you have for classes during this session.

If new, how did you hear about us?

* Photo/Video Release: The undersigned gives permission to Rosewood Players/Rosewood Productions, LLC, to use photos and/or videos of the participant for the marketing of their company and services. Rosewood Players and its owners and operators agree to do so without using any names or information about the participants. All visual materials remain the property of Rosewood Players. Families may have the opportunity to purchase videos of the productions. *

* Release of Liability: As the legal parent or guardian, I release and hold harmless Rosewood Players and Rosewood Productions, LLC, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Rosewood Players, Rosewood Productions, LLC, its owners and operators or in route to or from any of said premises. *

* Fees: I, the undersigned, understand that fees are due in full upon registration. Fees are due regardless of enrolled student's participation. *

Code of Conduct: I will review the Policies and Code of Conduct (available on our website), print and share with the student. I understand that if a student is dismissed because of conduct issues any tuition already paid is non-refundable. *

I have read and agree to all of the above. (Please type your full name below.) *

Today's Date *