Share My Story, Stage My Story
In this play writing & acting ensemble class, students will be challenged to write about their experiences on a variety of subjects.  They will then become directors as the other students help them play out their story onstage.
Sign in to Google to save your progress. Learn more
Ages: 11-15 / Monday-Friday; July 20-24, 9 am-4 pm / Tuition: $150 / Showcase: July 24 @ 4 pm
Please fill out the following information so that we may reserve a place for your child. This class meets at the Centennial Performing Arts Space, 211 27th Ave N.  Full tuition will be due on the first day of class July 20, unless payment plan accommodations have been made in advance.  We accept cash or check payment.  Checks can be made out to Arts in the Parks. For further information, please call Rachel at (615) 880-2281.
CONTACT INFORMATION
STUDENT NAME (Last, First) *
AGE *
DATE OF BIRTH *
SCHOOL STUDENT ATTENDS *
PARENT/GUARDIAN NAME *
ADDRESS *
CITY, STATE *
ZIP *
CELL PHONE *
HOME PHONE (if applicable)
PARENT/GUARDIAN E-MAIL *
(please include an e-mail for any adult that should receive information related to the class)
ALTERNATE CONTACT / RELATIONSHIP *
PHONE *
NAME OF ADULT PICKING UP STUDENT EACH DAY *
HAS YOUR CHILD HAD EXPERIENCE IN THEATRE? IF YES, PLEASE INDICATE PAST EXPERIENCES.
*
MEDICAL INFORMATION + RELEASE
NAME OF PHYSICIAN *
PHYSICIAN PHONE *
NAME OF INSURANCE *
INSURANCE POLICY # *
EMERGENCY CONTACT + RELATIONSHIP *
(In the event that a parent/guardian can not be reached in an emergency)
EMERGENCY CONTACT PHONE *
MEDICAL HISTORY *
Does your child have any medical concerns or allergies we should be aware of?  If yes, please explain.
MEDICAL HISTORY cont... *
Does your child have the need for any special accomodations?  If yes, please explain.
All students enrolling in Metro Parks Cultural Arts classes are hereby notified of the following participation policy. *
Parents/Students should be cognizant of inherent dangers in participating in a physical activity. All students should be in good physical condition and be capable of performing the class activities. All students must be covered by full, comprehensive medical insurance to cover any injuries sustained during the classes. Parents/students assume all risks in connection with the course in which they are enrolled. Parents/students should apprise the instructor of any special physical or medical limitations they have at the beginning of class.
Required
PHOTO RELEASE
I agree to allow my child's photograph to be used on the Metro Parks and/or Friends of Metro Dance or Arts in the Parks website and/or Facebook pages. Photographs will be of classes/performances/workshops and will not identify the children by name without further permission. *
E-MAIL LIST
I would like to receive the following e-newsletters:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms