CARMEL THEATRE COMPANYRising
Stars Academy Summer 2015 Class RegistrationSTUDENT’S NAME:
_______________________________________________________________________
AGE: _________GRADE: __________ SCHOOL:_______________________________________________
ADDRESS:
_______________________________________________________________________________
PHONE NUMBER:______________________________
CELL: ____________________________________
EMAIL ADDRESS: ________________________________________________________________________
EMERGENCY CONTACT NAME &
PHONE:__________________________________________________
HEALTH CONCERNS:
____________________________________________________________________
THEATER/STAGE EXPERIENCE: __________________________________________________________
__________________________________________________________________________________________
HOW DID YOU HEAR ABOUT CTC?:________________________________________________________
I WOULD LIKE TO REGISTER FOR:
________ ACTION – Teens
________
ACTION – Adults
________ DANCE BOOT CAMP I
________
DANCE BOOT CAMP II
________ TRIPLE THREAT TEENS I
________ TRIPLE THREAT TEENS II
________ INTRO TO THE STAGE ________ MUSICAL
THEATRE KIDS
I understand that I / my child may
be photographed during the above listed class and give permission to CTC to use
these photos in promotional materials. I
acknowledge that refunds will only be offered if the minimum enrollment is not
met. I release CTC, its directors,
officers, employees, and volunteers from all liability to me / my child for any
loss or damage to property or injury or death to person while I am / my child
is attending CTC activities. I agree to pick up my child promptly after each
class. Signature
________________________________________________________ Date__________________
Please mail enrollment forms with
check payable to
Carmel Theatre Company
to: CTC, 484 E. Carmel Dr. Box 162, Carmel, IN 46032 or
email completed forms to
jen@dossbs.com. We will
email you with confirmation of receipt and further information about the class. CTC will not offer refunds unless a class is
canceled due to low enrollment. Contact
Jen Doss at 317-727-3910 or
jen@dossbs.com with any questions.