The Big One-Oh - 2020
All registration information is available on our website. Payment can be completed there as well. Registration is not complete until this form has been completed and all payments received (or a payment plan is arranged). Upon completion of this form you will be directed to a link to complete your payment.
Student's Last Name *
Student's First Name *
Student's Age *
Students Preferred Pronouns (check all that apply) *
Student's Grade in Fall 2020 *
Student's School *
Student's Assigned School District Number *
Street Address *
City *
County *
State *
Zip Code *
Student's Email (if you'd like them to receive communications via email too)
Does your child have any limitations? Any medical or health conditions or concerns that we should be aware of? (if yes, please explain below) *
How did you hear about our program *
Primary Contact *
Primary Contact Phone (with area code) *
Primary Email contact *
Relation to Participant
Clear selection
Secondary Contact
Secondary Contact Phone (with area code)
Secondary Email contact - if needed
Relation to Participant
Clear selection
Student's Shirt Size *
Student's Pant Size (used for costume sizing) *
Sibling's Name, if any, that you are also registering - please do a new form for each child - Thank you!
How many family members are you registering? *
How do you identify your race(s), ethnicity(ies), and cultural group(s)? Check all that apply. (OPTIONAL: tracked so we understand the community we serve and it inform grant data for grant reporting purposes)
Photography: I give CPA the irrevocable right to use my child’s image(s) or voice for any purpose, including promotional materials, in all forms and media and in all manners including composite or distorted representation. I authorize CPA to copyright, use, reuse, copy, publish, edit, display, exhibit, reproduce, license to third party, and distribute the Materials for and in any educational or promotional materials or other forms of media, which may include, but are not limited to agency publications, catalogs, articles, websites, or otherwise, without notifying me. I waive all royalty fees for their use and manner of distribution. I also waive any right to inspect or approve the final version(s) including written copy that may be created in connection therewith. CPA will assure that it conveys positive images of my child(ren) and myself . I have read this release and am fully familiar and approve its contents. *
Assumption of Risk: I realize that no activity is without the possibility of unforeseen hazards, which could result in injury to an individual. As a parent/guardian, I am aware of the responsibility to instruct my child(ren) of the importance of conduct that will ensure safety and enjoyable time while participating in this activity. In consideration of the participation by myself and child(ren) and by signing this form, I, as a parent/guardian or other responsible party, agree to assume the risks and hazards, which are inherent in this kind of activity. I hereby release, indemnify, and hold harmless CPA and its staff, employees, agents and representatives from any and all liability whatsoever for damages, losses, or injuries (including death) that my child may sustain to his or her person or property, arising out of, resulting from, or occurring during his or her participation with CPA activities, except where such damage, loss or injury is the result of the intentional or reckless conduct of the CPA *
Volunteer and Handbook: Parent Volunteers and Background Checks. As a volunteer run organization, CPA can only be as beneficial to the participating children as the volunteers who apply their time and talents. We believe the pool of parent talents is as deep as the pool of talent in our participants, and encourage all parents to apply their talents to the production. Your volunteer commitment will create a truly magical experience for the participating children. All volunteers will be required to complete a background check (and have it on file) before working in rehearsal areas, theater, and back stage. There will be some volunteer opportunities that do not require a background check. Please check for the link, cost is $17.00. Please volunteer‐‐ your time and talents are an immeasurable gift to your children and to CPA. I and my child(ren), have read and agree to comply with the policies stated within the Children's Performing Arts Handbook and the Volunteer Requirements. You can find it at this link: *
Survey Release: I give permission for CPA to survey my child upon completion of the program. I understand that the survey might include questions about my child's experience in CPA programming and topics that directly relate to CPA's mission, vision and values. I understand that CPA will not quote my child's survey responses in any direct manner without first consulting with me. I understand that the primary purpose of the survey is general research to help CPA to progress and improve their services. *
I have a coupon code (leave blank if n/a):
I understand that registration will be complete and my child's spot reserved when payment is made through the website or mailed to the Hanifl Performing Arts Center c/o Children's Performing Arts, 4941 Long Ave White Bear Lake, MN 55110. Contact us to set up a payment plan. I understand that a volunteer and/or music deposit checks must be received through the mail or on the first night of rehearsal. All sales are final. No refunds or credits will be granted for non-attendance. *
Never submit passwords through Google Forms.
This form was created inside of Children's Performing Arts. Report Abuse