2024 Winter Stage Registration

Select the age range you wish to register for:

Child's Name

Child's Age

Child's Grade

Address: Street

Address: City

Address: State

Address: Zip

Parent/Guardian Name(s)

Parent/Guardian E-mail Address

Parent/Guardian Phone (###-###-####)

Child's Allergies (optional)

Does the student carry an epipen?Yes
No

Emergency Contact's Name(s)

Emergency Contact's Relationship to Child

Emergency Contact's Phone (###-###-####)

Authorized Pick Up Options

I accept that the Stadium may take photos of my child, which may be published online, or in print.I Accept

How did you hear about Winter Stage?

Please read the release below and check the box if you agreePlease read the following release and indemnification: In consideration of my child being permitted to participate in the program, I hereby release, waive, and discharge the Stadium Theatre, its directors, employees, and volunteers (collectively the "Stadium Theatre") from liability from any and all claims arising from negligence of the Stadium Theatre. I further agree to hold harmless, defend, and indemnify the Stadium Theatre against any and all claims arising from my child's injury or loss due to my child's participation in the program, including the inherent risks of the program activities and those arising from negligence of the Stadium Theatre. I authorize the Stadium Theatre to arrange for medical treatment for my child in the case of an emergency.