Willy Wonka - SESSION 7
Name: *
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Age: *
Birthday *
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Grade: *
Gender *
School you attend *
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Phone Number: *
Please add a main contact number and a 2nd number in case of emergency.
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Parent's Names: *
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Email Address: *
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I understand there is a $50 Participation Fee and understand I am not registered until this fee has been paid. Payment can be made online at www.CCCMT.org, click on make payment. *
I have read the Mini Musical FAQ's and agree to not miss any practices during the 2 week session. *
I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding. I give full permission and agree to waive all copyright and future considerations. *
I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact. In the event that we cannot be reached, I hereby authorize CCCMT to secure necessary medical treatment for my child. I further acknowledge that I will be responsible for any medical or hospital fees or costs associated with my child’s medical treatment. I assume all risks and hazards from participation in this production and hereby waive, release, absolve and indemnify and agree to hold harmless CCCMT , it’s organizers, sponsors, directors, volunteers, and participants for any claim arising out of accidental injury to my child. My signature below indicates that I have read, understand, and agree to the terms. *
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