Youth Class (Discover) Enrollment Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the below form to enroll your student in our programs! Please note that this enrollment form is step 1 of the enrollment process. For payments, please use the red BUY TICKETS tab at the top right hand corner of our website.

*For Summer Camp, sessions are open to students in 1st-8th grade (in the upcoming Fall quarter, not their current grade).

Email *

Please Select the course(s) you wish to enroll your child in: *

You can select more than one program if you are enrolling in several sessions.

No Classes Available

Required

Student's Name (First and Last) *

What are your student's pronouns? *

(ex: He/him, She/her, They/them)

Student's Email Address (if applicable)

Student's Cell Phone Number (if applicable)

Student's Grade *

Grade at the time the course begins. For Summer Camp, the grade the student will be entering in the Fall.

Student's Age *

At the start of the course

Student's Date of Birth *

YYYY

Parent/Guardian Address *

Student's School *

Parent/Guardian 1 Name *

Parent/Guardian 1 Email *

Parent/Guardian 1 Cell Phone *

Parent/Guardian 1 Home Phone

Parent/Guardian 2 Name

Parent/Guardian 2 Email

Parent/Guardian 2 Cell Phone

How did you hear about the STC School of the Arts? *

Returning Student

Internet Search/Website

Friend

Flyer

Show at STC

Facebook

Instagram

STC School Partnership Program

Magazine Ad

Other:

Please list any Medications, Special Needs, Disabilities, or Medical Diagnoses (ie: ADHD, Asthma, Diabetes, etc) *

Allergies or Other Medical Limitations *

Emergency Contact 1 Name *

Emergency Contact 1 Phone Number *

Emergency Contact 1 Relationship to Student *

Emergency Contact 2 Name

Emergency Contact 2 Phone Number

Emergency Contact 2 Relationship to Student

Physician to be Called in an Emergency *

Physician Phone Number *

Health Insurance Company *

Insurance Policy Number *

Is there additional information we should know about your child? *

Advertising: I consent to the STC School of the Arts Advertising and Promotion Release, which allows the reproduction and/or use of photographs, video, or audio recordings of my student for future STC advertising and promotional purposes. *

I agree

I do not agree. Photographs of my child may not be used for advertising/promotional purposes.

Medical Treatment: In case of an accident or an emergency, I authorize a staff member of the Sacramento Theatre Company to take my cihld to the above-mentioned physician, or to the nearest emergency hospital, for such emergency treatment and measures as are deemed necessary for the safety and protection of the child, at my expense. *

Administrative procedures vary among medical personnel and medical facilities with regard to provision of medical care for a child in the absence of the parent; the exact procedure required by the physician or hospital to be used in emergencies should be verified in advance.

I agree

Participant/Parent Agreement *

Please read and agree to the Student & Parent Agreement by clicking here.

I agree

Refund Policy *

I have read and agree to the refund policy explained at the top of this page. I understand that refunds are not given after 14 days prior to the program, and refunds granted before then will have a $50 administrative refund fee.

Required

Before you hit submit:

When you hit submit below, you should receive and email copy of your responses. The page will also accept your responses and change to a screen confirming receipt. You may need to scroll back up to the top of the page to see the confirmation message.

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms