Empowered Theater & Arts Registration
Welcome and thank you for registering at Empowered Theater & Arts! There are just a few details we need from you to complete your registration. These questions help us to understand who we are serving and how we can best help you. Thank you for the talent, passion and joy you bring to the arts.
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Email *
Participant Name *
Name of the participating artists, ally or volunteer.
Participant Email *
Email of the participating artists, ally or volunteer. Please type "None" if this person does not have an email.
Participant Primary Phone *
Phone number of the participating artists, ally or volunteer. 
Please type "None" if this person does not have a phone.
Secondary Phone
Secondary phone number of the participating artists, ally or volunteer. 
Please type "None" if this person does not have a phone.
Participant Birthday (month/day/year) *
Participant Address
Role in ETA *
Required
Dietary restrictions *
Disability Diagnosis *
Empowered does not base our interactions with people on their diagnosis. We take an individualized approach by speaking with each participant to assess their needs. The data gathered from this question will be used to understand who ETA serves as a organization. It also helps us explain to funders why they should support our mission.
Required
How can we best help you?
We want to provide the accommodations you need. Please share any details that could help us serve you. This section may be shared with the people who are working directly with you. If there are things you DO NOT want us to share, please write that here as well.

Here are a few examples of things you may want us to know:
- I need a quiet space when I'm anxious or overwhelmed.
- I would like a support person with me onstage.
- I don't like to be the center of attention.
- I need help walking up and down the stairs.
- Bright blinking lights give me seizures.
- I need time to think before I can answer questions.
- I don't like to be touched on the shoulders or arms.
Common Accommodations
Agreement of Participation *
I agree to participate at Empowered Theater and Arts. Participation includes timely attendance at rehearsals, events and performances. Participation also includes self-guided practice outside of rehearsals in preparation for the performances. Failure to fully participate in the program could result in dismissal and/or recasting. By signing I acknowledge that I have read, understand and agree to the terms stated above.
Guardianship and Support *
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