Enroll a Student 26-27 School Yr
Information we need on file for students, cast members, and all volunteers. 
ALL STUDENTS must have a NEW ENROLLMENT FORM on file for the new school year.
Sign in to Google to save your progress. Learn more
Student's First Name *
Student's Last Name *
Student's Grade *
Student's Age *
Birthdate *
MM
/
DD
/
YYYY
Pronouns *
Student's School *
Parent/Guardian 1 Name *
Parent/Guardian 1 Cell Number *
Parent/Guardian 1 Alt Phone Number *
Parent/Guardian 1 Email Address *
Parent/Guardian 1 Address *
Parent/Guardian 2 Name
Parent/Guardian 2 Cell Number
Parent/Guardian 2 Alt Phone Number
Parent/Guardian 2 Email Address
Emergency Contact 1 Name *
Emergency Contact 1 Phone Number
 *
Emergency Contact 1 Relationship to Student
 *
How did you hear about CFTC?
Physician to be called in an emergency  *
Physician's Phone Number  *
Hospital
Health Insurance Company *
Health Insurance Policy Number *
Allergies or other Medical Limitations *
Medications, Special needs, Disabilities, or Medical Diagnoses (i.e. ADHD, Asthma, Diabetes, etc.)
 *
Is there anything else we should know about your child? *
Advertising: I consent to Changing Faces Theater Company Advertising and Promotion Release, which allows the reproduction and/or use of photographs, video, or audio recordings of my student for future CFTC advertising and promotional purposes.
 *
Medical Treatment: In case of an accident or an emergency, I authorize a staff member of Changing Faces Theater Company to take my child to the above-mentioned physician, or to the nearest emergency hospital, for such emergency treatment and measures as are deemed necessary for the safety and protection of the child, at my expense.
 *
Parent & Student Agreement* Parent & Student Agreement *
Required
Refund Policy**
Requests for refund of program fees must be made 7 days prior to the first day of the course. NO TUITION REFUNDS WILL BE MADE AFTER THIS TIME. During the course, there is no refund for student illness, missed days, vacation, withdrawal, or if a student is dismissed by teachers. If withdrawal and tuition refund is requested prior to the refund deadline (7 days before the course), a $25.00 processing fee will be subtracted from the total refund.
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms