Performing Arts Academy Registration | Stage Door Theatre

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Registration*

Week(s)*

Weeks 3 & 4 Two-Week Intensive: High School Musical Jr.: June 14 - June 25, 2021
Week 5 Musical Theatre Level II: June 28 - July 2, 2021
Week 6 Technical Theatre: July 6 - July 9, 2021
Week 7 Acting Level II: July 12 - July 16, 2021
Weeks 8 & 9 Two-Week Intensive: Show TBD: July 19 - July 30, 2021
July: Summer Celebration (Virtual Camp)
July: Rockin' Summer (Virtual Camp)
One Month Package: 60-minute Virtual Voice
One Month Package: 40-minute Virtual Voice
One Month Package: 40-minute Virtual Piano
Two Month Package: 60-minute Virtual Voice
Two Month Package: 40-minute Virtual Voice
Two Month Package: 40-minute Virtual Piano

Guardian Name*

First Last

Guardian Email*

Guardian Phone*

Guardian Address*

Street Address City State ZIP Code

Alternate Guardian Name*

First Last

Alternate Guardian Email*

Alternate Guardian Phone*

Alternate Guardian Address*

Street Address City State ZIP Code

Child's Info

Child Name*

First Last

Preferred Name/Nickname*

Gender/Pronouns*

Allergies*

Date of Birth*

*If 18 must be registered for high school in Fall of 2021

Child’s school*

School grade level in Fall of 2021

Child's Grade In School*

Who is allowed to pick up*

Emergency Contact

Full Child Name*

First Middle Last

Emergency Contact Name*

First Middle Last

Relation to child*

Phone Number*

Necessary medical information (medications)*

Current Medications*

Medications to be taken during camp hours*

How did you hear about Stage Door Performing Arts Academy?*

Releases

Parental Authorization and Liability*

I agree to the liability release

Although every effort is made to ensure a safe environment, I realize there is always a risk of accidents. I authorize Stage Door Theatre to administer first aid treatment and/or emergency treatment for me/my child on my behalf should treatment be necessary. I further release Stage Door Theatre from all liabilities for injuries or damages arising out of personal injury of any kind.

Any medication needed by students is to be included in their medical information for the instructor upon registration. If not a pre-listed prescribed medication, students should not bring medications to class to self-administer.

Social Media/marketing*

I give Stage Door Theatre my permission to use photographs and videos of my child for marketing and advertising, online and in print. I hereby release all rights to Stage Door Theatre to exhibit this work.

Name Media Release*

I give Stage Door Theatre my permission to use my child’s name with any photographs and videos of my child for marketing and advertising, online and in print.

Email Mailing List

Yes

I would like my email to be added to the Stage Door Performing Arts Academy mailing list to receive newsletters and updates including information on classes, performance opportunities, and other community events.

COVID-19*

I agree to the COVID-19 release

By entering our facility, or participating in rehearsals with Stage Door Theatre I am aware that I agree to fully accept all known and unknown risks, including the potential risk of exposure to Coronavirus also known as COVID- 19 to me or my child. In order to help protect our teachers and students, we:
Regularly sanitize our spaces
Have enhanced our cleaning procedures to adhere with CDC guidelines
Enforce social distancing
Enforce mask-wearing and/or shields

I understand I/my child may still be exposed to the coronavirus (COVID-19) and/or its symptoms through no fault of Stage Door Theatre. I understand and agree that I hold Stage Door Theatre harmless and will not be held liable for any real or perceived symptoms of coronavirus (COVID-19) or any other disease, illness, or condition. I fully agree to accept all risks when entering this facility Stage Door Theatre.

I further certify that my child is in good health and has no symptoms of illness, conditions, or impairments that would preclude his/her safe participation in the Stage Door Academy programs.

I understand that if my child – at any time while participating in the Stage Door Academy camps or classes – presents any symptoms of illness (including but not limited to coughing or having a temperature at or above 100.4F) that my child will not be permitted to continue participating in the Stage Door Academy programs. Someone must immediately retrieve your student from the camp and said student will be isolated until a Guardian or approved adult pick-up your student.

Cancellation Policy*

I agree to the Cancellation Policy

By registering for a camp you are committing to be in attendance and pay for attendance of the camp. Any cancellations two weeks prior to the start date of the camp will receive a credit to their account worth 50% of the amount paid for the camp. Refunds will not be available less than two weeks (13 days) prior to the beginning of class.

Medical Needs and Medications*

I agree to the Medical Needs and Medications Policy

If your child has medical needs that might require our attention (i.e., nut allergy, Asthma), please make those details clear when completing the Emergency Contact Information form at registration. For medications that may need to be taken during camp hours (including EpiPen and asthma inhaler), you must complete the Permission to Dispense Medication Form below and submit it via email. All medication must be labeled and given to the Program Director on the first day of camp for proper storage, supervision, and dispensing.

Permission to Dispense Medication Form

Coupon

Total

$0.00