Student's Name * First Name Last Name Student Birthdate * MM DD YYYY Student's Gender Identity * Student Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Student's School * Student's Grade Fall 2023 * Student Email Address * Student Cell Phone (###) ### #### Summer 2024 Programs * Acting Up A : June 24th-28th Acting Up B: July 1st-3rd Moving Mythology: July 8th-19th Stories on Stage: July 22nd-26th SummerSlam: July 29th-August 2nd TeenScene: August 12th-16th Acting Up C: August 12th-16th None Fall 2024 Classes * Acting Up A: Fridays, 4:30-5:15PM, beg. 9/13/24 Acting Up B: Fridays, 5:25-6:10 PM, beg.9/13/24 201 A Mondays, 5:50-7:20 PM, beg. 9/9/24 201 B Thursdays, 4:15-5:45 PM, beg. 9/5/24 201 C Saturdays, 1:15-2:45 PM, beg. 9/7/24 301 Thursday, 4:15-5:45 PM, beg. 9/5/24 None Parent / Guardian #1 Name * First Name Last Name Parent / Guardian #1 Email * Parent / Guardian #1 Cell Phone * (###) ### #### Parent / Guardian #1 Home Phone (###) ### #### Parent / Guardian #1 Place of Work * Parent / Guardian #1 Position Title * Work Phone (###) ### #### Parent / Guardian #2 Name First Name Last Name Parent / Guardian #2 Email Parent / Guardian #2 Cell Phone (###) ### #### Parent / Guardian #2 Address (if different from above) Address 1 Address 2 City State/Province Zip/Postal Code Country Parent / Guardian #2 Place of Work Parent / Guardian #2 Position Title Please indicate any health concerns of which the Drama Studio instructors and administrators should be aware, especially allergies and/or special needs. This information is confidential and will only be seen by Drama Studio instructors and registration staff. Race/Ethnicity * Drama Studio is a 501(c)(3) non-profit organization that receives government funding. We are required to begin collecting general data on our students to provide our grantmakers with annual statistics. Your child's information is confidential and will be kept private. Please select the racial category with which your child most closely identifies. Multi Racial Hispanic or Latino (of Spanish culture or origin) African American or Black Native American or Alaska Native Caucasian (White) South Asian Other "I give permission for my child to participate in digital Drama Studio classwork, communications and performances, including the use of online video platforms/chat." * Yes, I grant permission NO, I do NOT grant permission "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." * Yes, I grant permission No, I do not grant permission Thank you for joining our Open House and submitting your registration. PLEASE NOTE: Your registration is not complete until you have received confirmation from the Drama Studio Office.
