School of Rock Tickets

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Registration for Performers only:

Actor's Name
Age:
Is there any additional information we should know? (Allergies, learning disabilities, physical impairments, etc.)
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Grade:
Parent's Name
Parent Cell Phone: (1)
-
Emergency Contact and Phone:
Address
E-mail*
Home Phone:
-

Release:

I give my permission for the Yorba Linda Spotlight Theater Company to use any photographic image taken of the actor being registered herein, to be used in printed publications, on the internet or in other electronic formats for press or print purposes. If the actor's image is used, I hereby consent, without further consideration or compensation to the use of images taken of the actor being registered, for the purposes mentioned above. I further understand that participation in this production may involve certain degrees of risk during dance, stagecraft, etc. and I have given my consent for the actor being registered to participate in these activities. I understand that participation in these activities is entirely voluntary and requires participants to abide by applicable rules and standards of conduct. I release all coordinators and all employees, volunteers, related parties from any and all claims or liability arising out of this participation. In case of emergency involving my child, I understand that every effort will be made to contact the individual listed as the emergency contact person. In the event that this person cannot be reached, permission is hereby given to the medical provider selected by the adult in charge to secure proper treatment.

I'd like a cast T-shirt (show logo on front, cast names on back) - $15.00.
I have read and agree with all release statements: (Enter your name) *
Tuition - $230.00
T-shirt Size
Total: