Registration Form Performances: Nov 18, 19, 20, 2011 Lakeshore High School Community Auditorium DFP use CD/L B E V Please send current photo of registering student with this form Student's Name (and/or nickname) Home Phone Number Street Address Male/Female City State Age Zip School Grade Date of Birth Parents Names email 2nd email Mom's Work Place Mom's Work Phone Mom's Cell Phone Dad's Work Place Dad's Work Phone Dad's Cell Phone Emergency Contact Name (nearest Friend or relative) Qty Emergency Contact Phone Emergency Contact add'l No. Group Grade Rehearsal (times vary) Fee 13 The Musical 6th - 12th Saturdays 12:30-4 $245.00 Amount There is no Rehearsal CD. We recommend you purchase the Broadway Soundtrack to familiarize yourself with the music. N/A N/A Optional: Student Book with dialogue and music - N/A at this time N/A N/A Optional: "13 The Musical" T-shirt Select Size* $15.00 Optional: Contribution to KOS Scholarship Fund *Additional T-shirt sizes may be ordered at checkout Kids On Stage Policies 1. Cancellation Policy: If you cancel your registration with less than a two weeks' notice before the class begins, no refund will be given. 2. $50 of tuition is non-refundable. 3. There will be no refund after August 27, 2011 4. Cancellation by KOS: We reserve the right to cancel a class if enrollment is insufficient. Any tuitionpaid will be refunded in full. 5. Please do not send your child to class if he/she is not feeling well. Sub-Total Fees Early Bird Discount on or before Sept 6 Scholarship applied requires prior approval N/A Total Fees *There will be a 4% processing fee added to all payments made by credit card. See bottom of page two for other payment options. Parents - Please Read and Sign the following Waiver By signing below, I agree to release and discharge Doug Fordyce Productions, LLC and its officers, directors, employees, volunteers and agents of and from any claims, demands, or liability of damage arising from the participation of my student in any classes or programs sponsored by Doug Fordyce Productions, LLC. I also give permission to Doug Fordyce Productions, LLC, without limitation or obligation, to photograph or video my student in relation to their participation with Doug Fordyce Productions, LLC. Photographs or video may be used for archival or promotional purposes. I also agree that there will be no registration refunds after August 27, 2011. I also agree that by registering my student and signing below, they WILL attend the MANDATORY rehearsals and all performances in their entirety. Mandatory rehearsals are: Nov 12 (8:30-5:00), and Nov 14 & 16 (4:30-8:00); Performances Nov 18 & 19 (7pm), Nov 20 (5 pm) . PLEASE DO NOT REGISTER YOUR CHILD if they will fail to attend any one of these without prior permission to miss. Typed name represents Parent/Guardian Signature Date Please list any scheduled vacations or other conflict dates the student will NOT attend rehearsal: for kids: We want to know about you and your theatre experience (It's ok if you don't have any experience, but feel free to brag) Name some plays you've been in, or roles you've had and the group or school you did it with: Any formal training in Dance? Gymnastics? Other? How much training (example 3 yrs. ballet, 2 yrs gymnastics): Name your singing experience and training (if you've had some): What are your interests and goals in theatre? Why do you want to attend KIDS ON STAGE? What are some of your hobbies, other than theatre? Name some of your favorite Singer/Songs, Website, etc. for parents: Where did you hear of KIDS ON STAGE? (Select from list or type in your answer) Is the Orientation meeting on your calendar for Sept 10 at 3:00 pm? Do you have a theatrical background? Care to elaborate? If you are interested in Volunteering during the production, check of any of the areas you are interested in - or type your suggestion here: Marketing Costumes Props Make Up Fundraisers Stage Crew Bake Cookies Dresser Child Supervision Set Construction Shoe Coordinator Concession Tech Week Dinner Help Cast Party Organizer Payment can be made in one of three ways: 1. Print this completed form and mail with check payable to DFP, PO Box 224, Stevensville, MI 49127 2. Fill out form, note the total fee, then go to www.dougskidsonstage.com/registrationonline.html and pay with your credit card. (If you have trouble submitting the form by email, try using a different browser) 3. Go to http://dougskidsonstage.com/registrationonline.html and pay with credit card. A 4% processing fee is added. Be sure to print and save a copy of this form for your records. Print Form Usher