Child's Name

Gender

Age and Birthdate of Child

PARENT'S NAME

ADDRESS (Address, City, State and Zip)

PHONE NUMBER

Is this a home or cell number?

EMAIL ADDRESS

EMERGENCY CONTACT NAME

EMERGENCY CONTACT INFO (Email and Phone)

Past Theater Experience (List below any acting, singing, dancing, technical theatre, experience you have-you may include a resume or use the back of this form)

RESUME (Optional)

HEADSHOT/CURRENT PHOTO

Does your child have any allergies?

If "Yes" for Allergies, please list below. If no allergies, please put N/A.

SPECIAL NOTICE: Students should bring water or a container for water. Due to COVID-19, we are limiting the number of registrations we obtain. Registration deadline is by 5PM on October 2nd. Acceptance emails will go out the week of October 12th. Please understand Staff/Volunteers are not allowed to give out medication during rehearsal. If your child takes medication, please make sure he/she has taken the medication prior to arriving at camp. Our Staff/Volunteers are not nurses or doctors and therefore can not give out medication.

CONSENT: I, the undersigned Parent or Guardian of this student, a minor, do hereby authorize the directors and teachers of HUG ME Ink as agents for the undersigned to consent to medical emergency treatment. I hereby release HUG ME Ink and its Board of Directors from any and all claims from personal injuries. I also consent that student’s photo or video may be taken and used for any purpose deemed necessary to promote HUG ME Ink’s education program without compensation.

Would you be able to pay an enrollment fee to cover Academy T-shirt, Performance DVD, Costumes, and Snacks?

Due to COVID-19, we are still in the middle of planning how this Academy would work. Because we can't have a lot of people at the same time, we are looking to host different time periods. Please indicate which time of day works best for you on a Saturday for your child to attend. Check all that applies.