Pure Imagination Registration
Theatre Camp & Pure Imagination Production
Performer Name
*
First Name
Last Name
Age
*
Birthdate
*
Example: 4/30/2015
Briefly explain prior class/ performnace experience. Or upload resumer below.
Upload a performance resume.
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Upload a headshot or photo
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Performer Phone {if applicable}
-
Area Code
Phone Number
Performer email {if applicable}
example@example.com
Please share any health or learning conditions.
*
Help us meet the needs of our cast members. (If none write none)
General Contact Info
Parent or guardian
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Parent email
*
You will receive program info through this e-mail address
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please share how you heard about our workshop.
*
Waiver of Liability & Photo Release
By signing below I agree and understand that T3 activities involve physical activities and may have a small risk of injury. In consideration for my child’s participation in this activity, I hereby agree to hold T3 Triple Threat Youth Mentors (T3), or any of its affiliates harmless for any injury to myself/my child resulting from me/my child’s participation. I will not sue T3 or any of its affiliates for any injury, loss of property, or damage resulting from my child’s participation in this activity. I agree that participants are expected to follow all rules and instructions set out by the instructors at T3. Additionally, I give my permission and understand T3 may use any photos and video footage taken for future promotional purposes.
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