Driftwood Theatre School Registration Register online with this form, which, when submitted, is sent directly to the registrar. CompanyThis field is for validation purposes and should be left unchanged.COURSE(Required)STUDENTSTUDENT NAME(Required)AgeDate of Birth DD slash MM slash YYYY GradeSchoolHome addressTownPostal CodePhoneRegistration contact email(Required) PARENT / GUARDIANMOTHER / GUARDIANContact phone numberEmail FATHER / GUARDIANContact Phone NumberEmail FOR IN-PERSON CLASSES ONLYFamily DoctorPhoneBC Personal Health Care NumberEmergency ContactPhoneADDITIONAL INFORMATIONPast involvement in Performing ArtsReading AbilityHealth issues / Special needsHow did you hear about the Driftwood Theatre School?LIABILITY AGREEMENTLiability Agreement(Required) 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. Guardian(Required)Date Day Month Year PUBLICITY / MEDIA WAIVERConsent for useI 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 DTS publictiy Personal use by friends and family of students involved in class/production Recorded performances posted to Driftwood Theatre School Online use Live performances and performance screenings Guardian Publicity / Media WaiverDate Day Month YYYY I agree to abide by the Driftwood Theatre School Code of Conduct(Required) I agree Guardian form submission consent(Required) By submitting this form I agree to the use of submitted information by the Driftwood Theatre School. Guardian name(Required)
