CAST We Play all the time!

200 South Center Street, Hildebran, NC 28637

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 Just copy/paste it into an email or print it out.

CAST Flip-Flop Summer Theatre Registration Form
                       (Please print clearly and fill out one form per student)

Student’s Name:______________________________________________________

Age: ____________ Date of Birth:____________________ M/F: ______________

 

Parent’s Name(s):_____________________________________________________

_____________________________________________________________________

 


Parent’s Email:________________________________________________________

 

Student's Email: ______________________________________________________

 

Home Phone:________________________ Work: ___________________________

 
Cell: _______________________________
 
Name of School student attends:__________________________________________

Does your child have any medical conditions we need to know about?

Yes _____ No _____
 
Explain: ______________________________________________________________
 
_____________________________________________________________________


Emergency Contact(s):_________________________________________________
 
____________________________________________________________________

Relationship to the Student:_____________________________________________
 
_____________________________________________________________________
 
Phone Numbers: (H)_______________________(Other)_______________________

If in the event of an emergency, we cannot contact you or the emergency contact, do we have permission to call 911 or seek immediate medical attention?

Yes _____ No _____