Theater Tech Registration Form 2021-22 Art for Social Change
Learn All About What Happens Backstage!

Theater Tech is a unique 6-12th Grade opportunity for learning how to build and paint sets, Construct props, use hand tools, learn about stage lights and what is involved in stage sound.

Experience the fun of designing, drawing and building sets from our expert teacher Douglas Fry.

Theater Tech runs every Tuesday from September 21-Dec 15, between 4-5:30pm.
Name: *
Address: *
Phone Number *
Email *
School and grade level *
Preferred Pronoun (He/She/They): *
Ethnicity (optional)
Does your family qualify for free or reduced lunch (optional)?
Clear selection
Emergency Contact Name and phone number: *
Food Allergies/Medical Conditions: *
Do you want your child to be picked up and taken to the ArtsHub by Lafayette Free Ride?
Clear selection
Other Considerations: I give my child/children permission to participate in Art for Social Change and I hereby release and forever discharge and hold harmless the Lafayette Empowerment Center and its staff members, volunteers, and community partners from any and all liability, claims, and demands of whatever kind or nature, which arise or may hereafter arise from the below named minor child’s participation in this program. I also give the Lafayette Empowerment Center permission to photograph my child for outreach and reporting purposes. By submitting this form I am agreeing to the above statement. Guardian Name: *
Please let us know if you have any questions. stephanie@lafayetteempowerment.org or 720-204-8466
Submit
Never submit passwords through Google Forms.
This form was created inside of Lafayette Empowerment Center. Report Abuse