June 9, 2017 Roseneath Theatre PA Day Drama Camp Registration
This camp is for ages 6-11 years old. Contact us with any questions 416-686-5199 ext 223.
Email address
Child's First Name
Your answer
Child's Last Name
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Child's Age
Must be 6-11 years old
Your answer
What pronoun does your child prefer? (ie: he, she, they)
Your answer
Parent/Guardian Name
Your answer
Parent/Guardian Email Address
Your answer
Mailing Address
Your answer
Primary phone
(first number you would wish to be reached at)
Your answer
Secondary phone
(another number where we can reach you)
Your answer
Who is authorized to pick up your child?
Please list anyone who might be picking up your child
Your answer
Emergency/Secondary Contact
Please provide name and phone number
Your answer
Does your child have any previous Theatre Arts/performing Arts experience (Classes etc)?
Your answer
Is there any other information you wish to share about your child or that the instructors should be aware of?
(ie: medical, medications, allergies etc)
Your answer
Please let us know what hours your child will attend.
Families enrolling more than one sibling pay a discounted sibling fee for the second child enrolled.
Required
What is your method of payment?
Please pay in advance to guarantee a spot in the camp.
Required
Do you agree with this release statement?
I am the parent or legal guardian of the child mentioned above (the “Student”), who is under 18 years of age. I agree that the Student participate in the full school programs and activities (the “Activities”) of the Drama school of Roseneath Theatre (the “Theatre”). I acknowledge that I must advise the Theatre in writing if the Student is not physically fit to participate fully in the Activities. I also acknowledge that there are risks in participating in the Activities. I agree that, having taken such precautions as in its discretion are deemed advisable, the Theatre will not be held responsible for any injury, sickness or accident to the Student or for any loss or damage to personal property resulting from the Student participating in the Activities. I authorize the Theatre to secure medical care for the Student. If for any reason the Student requires medical attention beyond any first aid furnished by or on behalf of the Theatre, I agree to be responsible for any expenses incurred. I agree to indemnify the Theatre, its officers, directors, agents and employees and save them harmless from and with respect to all suits, actions and prosecutions by reason of any Activity carried out by the Student, whether on or off the Theatre’s property.
Required
Do you consent to the use of photography and video?
I consent to the use of the likeness (including still photographs and video) of the Student in connection with the drama programs of the Theatre and related institutional promotional purposes throughout the world and without any compensation. I expressly release the Theatre, its officers, directors, agents, employees, licenses and assigns from and against any and all claims for invasion of privacy, defamation, infringement of copyright or any other cause of action that may arise out of such use. I hereby irrevocably release the Theatre from any and all claims for libel and invasion of privacy in connection with the foregoing.
Required
A copy of your responses will be emailed to the address you provided.
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