Contact Phone #1 *

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Contact Phone #2 (if applicable)

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Contact Phone #1

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Contact Phone #2

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Emergency Phone # *

Please provide the phone # for the person listed above

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CTW Agreements *

CTW Registration Agreements: • Please note that while no previous theater experience is necessary. LCP requires that the child have an interest in being involved in the workshop! The workshop will create a supportive and safe environment for the child to try something new; we only ask that they come willing to try and willing to say “Yes!” If your child is not interested in participating or is disrupting the participation of others, we reserve the right to dismiss the child from the CTW (the Registration Fee will be refunded). • Each child should bring their own bag lunch and beverage each day as well as a beach towel. Children should wear comfortable clothes that allow them to sit, lay and roll on the floor, as well as socks, tennis shoes and any dance shoes they may have that will not leave scuff marks. Everything should be able to get dirty, and never hinder movement or imagination. Each child should also bring a 3-ring binder and several pencils each day, and all items should be marked with the child’s name. • The CTW will take place at the historic Hyde Park Opera House, from 9:00 am to 3:00 pm each day. • I give permission for LCP to use my child’s photo for CTW publicity purposes. • In consideration for being allowed to participate in this Activity, I release from liability and waive my right to sue the Lamoille County Players, their officers, volunteers and agents (collectively “LCP”) from any and all claims, including claims of LCP’s negligence, resulting in any physical injury, illness (including death) or economic loss I may suffer or which may result from my participation in this Activity, travel to and from the Activity (including air travel), or any events incidental to this Activity.

I understand and agree to the above policies.

Scholarship Amount Requested *

Please indicate if you are requesting a full or partial scholarship

I am requesting a partial scholarship of $100. (I agree to pay the remaining $75.)

I am requesting the full scholarship of $175.