Register online – DRIFTWOOD THEATRE SCHOOL

Online Registration Form Fall 2023

COURSE

STUDENT

STUDENT NAME

Age

Date of Birth

Grade

School

Home address

Town

Postal Code

Phone

PARENT / GUARDIAN

MOTHER / GUARDIAN

Contact phone number

FATHER / GUARDIAN

Contact Phone Number

FOR IN-PERSON CLASSES ONLY

Family Doctor

Phone

BC Personal Health Care Number

Emergency Contact

Phone

ADDITIONAL INFORMATION

Past involvement in Performing Arts

Reading Ability

Health issues / Special needs

How did you hear about the Driftwood Theatre School?

LIABILITY AGREEMENT

I, as the parent / guardian of of the above-named student agree to hold harmless the Driftwood Players / Driftwood Theatre School, their officers, or staff from any claims of injuries sustained during drama classes, performances or rehearsals.

Liability Agreement(Required)

I agree

Guardian(Required)

Date

PUBLICITY / MEDIA WAIVER

I hearby give my consent to Driftwood Players / Driftwood Theatre School to use the above-named student’s image or audio in the form of a photograph, video, likeness or other recording or reproductions for the following purposes without payment of any fee or charge:

(check all options for which you grant permission)

Instructional purposes

live performances and performance screenings

DTS publictiy

personal use by friends and family of students involved in class/production

recorded performances posted to Driftwood Theatre School Online use

Guardian

Date

Guardian form submission consent(Required)

By submitting this form I agree to the use of submitted information by by The Driftwood Theatre School.

Guardian name(Required)

This field is for validation purposes and should be left unchanged.