Act Out Registration
Ages 8 and up. Please fill in all areas of this form. Participation fee of $250 is due upon registration. You can pay via Venmo (NC-TC), check, credit card (if by credit card there is a 5% service charge) or cash (in person). *If you pay via Venmo and select "payment protection" please add 3% to the total to cover the payment protection fee. If NCTC needs to cancel the program prior to beginning the program for any reason, you will receive a full refund. If NCTC needs to cancel the during the program, you will receive a pro-rated refund.


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Child's Name *
Child's Date of Birth *
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Parent Name *
Parent Email *
Alternate Email for Google Classroom Invite *
Street Address *
Town *
State *
Zip *
Child's shirt size (for costumes and NCTC shirt) *
Child's pant size (for costumes) *
Grade *
School *
Cell Number *
Emergency Contact Name (other than yourself) *
Emergency Contact Phone Number *
Are you interested in volunteering at the performance? *
I give my child, mentioned above, permission to participate in NCTC's ACT OUT (listed above). My child my be photographed and/or videotaped during the course of the program. I understand that NCTC may use such images for archival and promotional purposes. *
Required
I understand and agree that there are NO REFUNDS/CREDITS/TRANSFERS GIVEN after the first rehearsal.
*
Date signed *
MM
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DD
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YYYY
How will you be rendering payment ($250)?   *
Required
Would you like to be added to our email newsletter list? *
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