CARMEL THEATRE COMPANY
Rising Stars Academy Summer 2015 Class Registration
STUDENT’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.
Rising Stars Academy Summer 2015 Class Registration
STUDENT’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.
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