Back to All About Music Children's Theatre

  Back to All About Music

All About Music & Children’s Theatre

19108 Wolf Road Mokena, IL  60448  708-479-0440

ACTING CLASS REGISTRATION FALL 09   (may print as 2 pages)

Please complete and return to All About Music.  Registration is on a first come first serve basis and space is limited. 

(Please print)

Student’s Name:________________________________________________________________

Parent’s Name: _________________________________________________________________

Address: ______________________________________________________________________

City: ____________________________________________ Zip: ____________________

Phone: ________________________________ Cell Phone: _____________________________

E-mail address: ___________________________________________________________

Student’s Grade in School: __________ Age: _______Date of Birth: ______/______/______

Intro To Music Theatre $99     Music Theatre I  $99     Intro to Acting $69     Acting I $75     Music In Motion $59  (circle one)

Payment: Cash: _______Check #: ________________Amount: _________________

Please list and medical conditions, allergies or medications we should be aware of: _______________________

_______________________________________________________________________________________

If parents can’t be reached, whom should we contact in case of emergency?

Name: ________________________________________ Phone: (______)__________________

My son/daughter (Child’s name) _________________________________________________________ has my permission to participate in the All About Music, Inc. acting classes. (Herein referred to as the Company).  As Child’s Parent or Guardian, I release the Company from any and all liability, damages, or claims whatsoever for any injury or harm that may occur to my Child while participating in any rehearsal, activity or performance provided by the Company.  I agree that I will make no claim or demand against the Company if an injury or accident occurs during any rehearsal, activity or performance provided by the Company.  I will look to my own resources, insurance or assets to pay all medical bills, damages or losses whatsoever if any injury occurs.  The term Company includes all employees, subcontractors, volunteers or other staff of the Company participating in the acting classes.  The Company may use any photographs taken of my Child while participating in the acting classes for publicity or promotion.  I also give my permission release my Child to the emergency contact listed above.