Registration Form

Registration Fom

NOTE: If you have already filled out this Parent/Guardian Registration form you can skip this step and proceed to the Student Registration for your desired class/camp/workshop:

Summer Camp Student Registration

Parent/Guardian Registration

Parent/Guardian First name

Parent/Guardian Last Name

Addt'l Email

Street Address

City

Phone

State

Zip code

Addt'l Phone

Emergency Contact First Name

Emergency Contact Relationship

Emergency Contact Last Name

Emergency Contact Phone

We do our best to accomodate students with special needs, however we are not formally trained in this area. We ask that parents of children with significant social, behavorial, or develomental challenges be on the premises during class. Or even better, become a class assistant.

Would you like to join our Volunteer Program?

Volunteer Ideas

Informed Consent & Acknowledgements

I/we hereby give my approval for my/our child(ren)'s participation in any and all activities prepared by YPPC staff and volunteers. I/we realize that participating in Theatre classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By agreeing to this notice, I/we, the parent/guardian(s) of the child(ren) listed above, assume all risks related to the use of any and all spaces used by YPPC at the Durham Arts Council.

Hold Harmless

I/we agree to hold harmless YPPC, YPPC Staff, and the Durham Arts Council for any cause of action, claims or demands, now or in the future. I/we will not hold the aforementioned liable for any personal injury or personal property damage which may occur on the premises during or after class activities. Furthermore, I/we agree to follow the class and facility rules and take full responsibility of my/our behavior as part of the YPPC program.

Media Disclosure

Members of YPPC may periodically photograph students participating in our programs. These photographs may be used in a variety of ways; Public relations and marketing purposes: images printed on brochures, posters, and newsletters, or on other art, education, or news related publications. Please indicate whether you will allow publication of photographs taken of your child/children. Names will not be included in photographs or posted on social media. We appreciate your support and would love the chance to share pictures of all of the fun being had in our theatre and movement classes

If you disagree, please let your child know that teachers or staff may need to take photos and will be sure to let your child know so they can step aside for a quick moment.

Confirmation & Signature

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Young People's Performing Company

Parent/Guardian Registration

Young People's Performance Company