ROYAL: Registration (250)

Actor's Name*

First Name

Last Name

Age*

Parents' Name

First Name

Last Name

Phone

Family Email*

Allergies or other notes

Emergency Contact Name (1)

First Name

Last Name

Emergency Contact Phone (1)

Emergency Contact Name (2)

First Name

Last Name

Emergency Contact Phone (2)

Emergency Contact Name (3)

First Name

Last Name

Emergency Contact Phone (3)

Do we have your permission to photograph or video your actor in class for ROYAL promotional use?*

Yes No

In case of an emergency, do we have your permission to transport your child to the hospital?*

Yes No

While the ROYAL Theatre Company, Home of The Children’s Theatre of Mason, its owners, and employees will maintain proper safeguards at all times, I realize that my child will be actively involved in vigorous physical activities while in rehearsal, on stage, or in classes/camps/workshops. ROYAL makes no representation either written or implied regarding physical capabilities of a student though activities are planned to meet the overall requirements for each group or class. I will not hold ROYAL or its instructors responsible for accidents or injuries resulting from normal activities or student negligence.*

Yes No

Class*

Makeup Kit (Additional $20)

Quantity

Cost