Student's Name *
Student's Name
Student Address *
Student Address
Student Birthdate *
Student Birthdate
Student Cell Phone
Student Cell Phone
Parent / Guardian #1 Name *
Parent / Guardian #1 Name
Parent / Guardian #1 Cell Phone *
Parent / Guardian #1 Cell Phone
Parent / Guardian #1 Home Phone
Parent / Guardian #1 Home Phone
Work Phone
Work Phone
Parent / Guardian #2 Name
Parent / Guardian #2 Name
Parent / Guardian #2 Cell Phone
Parent / Guardian #2 Cell Phone
Parent / Guardian #2 Address (if different from above)
Parent / Guardian #2 Address (if different from above)
This information is confidential and will only be seen by Drama Studio instructors and registration staff.
I grant to the Drama Studio, its representatives and employees, the right to take theatrical photographs/videos of my child(ren). I authorize the Drama Studio to copyright, use and publish the same in print and/or electronically. I agree that the Drama Studio may use such photographs/videos of my child(ren) with or without name(s) and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.