Information about you:

Information about your student:

Program Registration:

Select the program for which you wish to register your child:

Referral Information:

Emergency Contacts & Pickup Information:

Emergency Medical Authorization:

In the event of illness, injury, or accident involving my child and if I cannot be contacted in a timely manner, I authorize program staff to seek emergency medical attention for my child, including examination, diagnostic testing, first aid, transportation, hospital admission when recommended, and the administration of medication or other treatment deemed necessary by licensed medical personnel. I understand this consent is intended for extreme or emergency situations only and does not replace routine parental consent.

Photo / Video Consent:

I give permission for program staff to photograph and/or video record my child during program activities and to use those images or recordings for publicity, promotion, website content, social media, newsletters, and related outreach. I understand that SVTC may use group or individual photos.

Parent / Guardian Agreement:

Shenandoah Valley Theatre Collective is a faith-based theatre education program committed to create a safe, respectful, and encouraging environment for all participants.

Assumption of Risk

I, the undersigned parent or legal guardian of the above named child ("student"), understand that the participation in theatre activities involves inherent risks, including but not limed to: physical activity (such as movement, dance, stage combat exercises, and games), use of props, use of basic stage equipment, participation in rehearsals and performances, and general risks associated with group programs for children.

I understand that these activities may result in minor injuries (such as bumps, bruises, sprains), and, in rare cases, more serious injuries. I acknowledge and voluntarily assume all risks of injury or harm arising from my child's participation in this program, whether known or unknown, foreseeable or unforeseeable.

Personal Property

I understand that the program is not responsible for loss, theft, or damage to personal property that my child brings to the program sessions, including but not limited to phones, electronic devices, clothing, costumes brought from home, or other personal items.

Compliance with Rules

I understand that my child is expected to follow all program rules and staff instructions. I acknowledge that serious or repeated violation of the Code of Conduct may result in my child's removal from the program, and I understand that no tuition refunds are guaranteed in such cases, consistent with the program's cancellation and refund policy.

Acknowledgment

I have carefully read this General Liability Waiver and Release of Claims. I understand its terms, understand that I am (for program hours) giving up substantial legal rights for myself and my child, and sign it freely and voluntarily.

Indemnification

I agree to indemnify and hold harmless the program, its owners, directors, officers, employees, contractors, and volunteers from any loss, liability, damage, or cost (including reasonable attorneys' fees) they may incur due to my child's participation in the program, my child's violation of program rules, or my failure to comply with the terms of this agreement.

Medical Treatment

In the event of illness or injury, I authorize program staff/leadership to seek emergency medical care for my child as described in the Emergency Medical Authorization section of the registration packet. I understand and agree that I am financially responsible for all medical treatment and related costs.

Electronic Signature Agreement:

By typing my full legal name below, I certify that I am the parent or legal guardian of the child listed above; I have read and consent to the above Emergency Medical, Photo/Video, and Parent consents and agreements; and that my typed name serves as my electronic signature, with the same force and effect as handwritten signature.