WAIVER AND RELEASE
KIDSWORKS Waiver & Release
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NAME of SHOW or class:
*
NAME of Applicant
*
AGE:
*
FULL ADDRESS:
*
Parent/Guardian Name:
*
Parent / Guardian Email address
*
Parent/Guardian Phone (cell)
*
Phone (other)
EMERGENCY CONTACT Name:
*
EMERGENCY CONTACT Phone Number:
*
Any allergies or medical conditions we should be aware of?  Makeup may be used in a production:
*
Can Photos be used for publicity of the applicant?
*
Required
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