Community Theater Performance Release Form

Community Theater Performance Release Form
Please complete this form to provide necessary permissions and information for participation in a community theater production.
Participant's Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you under 18 years of age?
Parent/Guardian Full Name (if under 18)
First NameLast Name
Production/Performance Title
Role or Position in the Production
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list any allergies or medical conditions we should be aware of
Participant Signature
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