Class Enrollment Form

Select Saturday and weekday evening classes and rehearsals: Acting, Dance, Voice, Stage Performance, Stage Production, Props, Ect. For the purpose of Artistic enrichment, Artistic production (written, video, marketing, and live community performances): TIMMY’S DANCE the Musical - Scheduled June 15th (2pm & 5:30pm), Dress Rehearsal June 12th .

Guardian / Adult Name *

First

Last

permit my *

child children self

To attend the artistic session indicated above and agree to follow the rules at hand. I am responsible for my or my child’s actions, including damages to product(s) and or property of 619 Productions and connected venues. I understand that 619 Productions, Inc. is not responsible for any physical injuries (sprains, pulled muscles, illnesses, broken limbs, etc.) that may occur in class or on property. I agree that my child will be present for the entire 1 hour class time. I am also aware that any conduct / behavior problems (excessive defiance, fighting, harm to others, etc.) will be grounds for student dismissal from the program. We encourage excellence, appropriate behavior and punctuality. All students who enroll in these classes will perform live at Community Centers, potentially other city locations and the 619 Productions live “Timmy's Dance” musical at the IM Terrell Performance Hall. I agree that any images/video/audio of my child or myself will be used only for marketing purposes for organizations website, entertainment purposes & social or print media. I understand that typing my full name in the space below constitutes my legal signature on this agreement. Thank you for your cooperation. Now let the creativity begin. *

Date *

Class Enrollment Form

619 Productions Enrollment Form