TO REGISTER FOR CLASSES:

Please Fill out this form in its entirety! Your child is not registered until

Liability Waiver and Code of Conduct Forms are signed!

For our records we need a separate registration form submitted for each student.

Student First name

Student Last Name

Student Date of birth

Month

Day

Year

Please List all classes you would like to register this student for:

Does your child have any special needs, diagnoses, or support needs we should know about to best support them in class? Please be as detailed as you’d like — if none, just write N/A.

Parent/Guardian First and Last

Parent/Guardian Phone #

Parent/Guardian Email

Emergency Contact Name

Emergency Contact Phone

I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER PARTICIPATION, AGREEMENT, LIABILITY WAIVER, AND POLICY ACKNOWLEDGEMENT,

https://www.imagineperformingartscenter.org/liabilitywaiver

By signing, I acknowledge that I have read, understood, and agree to all the terms and conditions stated in this agreement.

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I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER STUDENT CODE OF CONDUCT

https://www.imagineperformingartscenter.org/codeofconduct

By signing, I confirm that I have read, understood, and agree to the student code of conduct, and I am aware of the consequences of not adhering to it.

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