Teen-Versionary Sign Up
Welcome to Diversionary Theater's LGBT ensemble! Please fill in the form below for each child you are enrolling. We will be meeting in the Black Box Theatre located on the second floor of the Theatre building in the back. 4545 Park Blvd. Thanks for giving your child the gift of creativity, and we will see you soon. Performances will be on Friday July 20th.
Teen's name *
Your answer
Teen's email address *
Your answer
Teen's grade completed Spring '18 *
Your child's age *
Your answer
Parent or Guardian Name *
Your answer
Parents contact Information phone *
Your answer
Parents Contact Email *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Allergy / or Medical info *
Your answer
Anything else about your teen you would like to share
Your answer
Pick Up info *
Terms of Agreement: By signing & submitting this form you agree to permit your child to attend the Teen-Versionary summer program. Parents/Guardians agree to hold harmless Diversionary Theatre, its employees, volunteers & all others working on behalf of the company against any and all claims, demands, suits, and any damages asserted, claimed or recovered against the company, its elected and/or appointed officials, by reason of personal injury, including bodily injury or death and/or personal damage, which is connected with this contract. You understand it is your responsibility to arrange for adult supervision immediately after the class. ​Parent/guardian picking up MUST come to the class site to retrieve their student. Students will not be allowed to walk home without written permission. You agree to allow your child to appear on photos and video for archival purposes as well as grant applications. © 2018 All Products Copyrighted & All Rights Reserved, Diversionary Theatre. Cancellation Policy: No refunds will be given after 6/1. Thanks. *
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