Florida Studio Theatre | Spring Break Camp: Little Theatre: The Plays The Thing

Spring Break Camp: Little Theatre: The Plays The Thing

Friday, March 22, 2019

General

Regular ($30.00)

Child's Name
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Child's Date of Birth
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Child's Age
Child's School
Parent Cell Phone
Family Doctor and Contact Info
Does your child have any allergies? If yes, please list in the box belowNo Yes
Does your child have learning difficulties? If yes, please explain:No Yes
Other adult contact in case of emergency
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1. Name
2. Address
4. City
5. State
6. Zip Code
7. Country:
Phone
RELEASES
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In the event of an accident, I allow emergency medical treatment from a qualified professional (hospital, doctor, etc).
*
Yes I authorize No I do not
I hereby authorize Florida Studio Theatre to publish the photographs taken of this student, for use in Florida Studio Theatre’s printed publications and website. I acknowledge that since this participation in publications and websites produced by Florida Studio Theatre is voluntary, I will receive no financial compensation. I further agree that my participation in any publication and website produced by Florida Studio Theatre confers upon me or the student no rights of ownership whatsoever. I release Florida Studio Theatre, its contractors and its employees from liability for any claims by me or any third party in connection with this participation.
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Yes I authorize No I do not