W.H.A.T. Education Program - Summer 2017 Registration
Student Name
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School
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Birthday
MM
/
DD
/
YYYY
Current Grade
Age
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Parent/Guardian Name(s)
Your answer
Home Address
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City
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Zipcode
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Home Phone Number
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Cell Phone Number
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Parent Email
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Student Email
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Does your child have any medical/allergies that the staff should be made aware of?
Does Your Child Have a prescribed epi-pen or inhaler?
How will your child be dismissed from the program?
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Disclaimer
I, the undersigned, hereby indemnify, defend, and hold harmless West Hudson Arts 8 Theater Company [WHAT] its directors, agents, and employees and other officials from any claims, including: liability, loss, damage (to persons or property) and expenses (including attorney fees) which may arise as a result of my child's participation in this program. Photographs can be used for program promotion. Also, I give permission for my child or me to receive emergency medical care. I understand there are no refunds for missed classes or performances after the second class meeting. I understand there Is a fee for checks returned to WHAT by the bank. Appropriate behavior and attire are expected. Students may be dismissed from class due to inappropriate behavior. All casting decisions made by the staff are final. Students must be available for all performance dates. Space is limited; participants will be registered on a first-come, first-serve basis.
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