Business Ads

Business Ads Form

CTW audiences range from 300-450 people per production!

Business Ad Due Dates:

A Spare Me: October 24, 2016
I Did It All For The Cookie: November 14, 2016
The Mysterious Case of the Missing Ring: February 27, 2017

After you submit, you will be taken to a page for the option to pay via Paypal. You will receive a confirmation email within a few hours of submitting. If you do not receive it, please check your spam folder. Contact our office if you have any questions!

Student Name:*

First

Last

Student Age: *

Select Your Spring Break Workshop: *

April 18 (ages 7-9)

April 20 (ages 10-14)

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Name of Student's School

Student Gender:*

Female

Male

Prefer Not To Specify/Other

Student Ethnicity:

Asian/Pacific Islander

Black or African American

Caucasian

Native American or American Indian

Hispanic or Latino/a/x

My race/ethnicity is not represented in this list

Guardian Name:*

First

Last

Guardian E-mail:*

Guardian Phone:*

Area Code

 - 

Phone Number

Second Guardian Name (as applies):

Second Guardian Email:

Second Guardian Phone:

Area Code

 - 

Phone Number

Please provide any medical information we should know about while your student is with us:

If your student has differing abilities, please let us know if there are any insights we should be aware of, or accommodations we can make, for your student's best experience. Or write "Please contact me to arrange" so we can discuss a personalized plan.

Emergency Contact (if Guardians are unavailable)*

First

Last

Emergency Contact Phone:*

Area Code

 - 

Phone Number

I will pay for the workshop by:*

Paypal

Check

My child has permission to participate in Children’s Theatre Workshop. CTW has the right to use photos of my child for promotional purposes. Photos could be from classtime, rehearsals, performances, etc. I understand that in the event of an emergency, every effort will be made to contact the people named above, but CTW reserves the right to exercise judgment in calling 911 in the case of an emergency. I understand that my child’s participating in CTW is potentially hazardous, and I assume full and complete responsibility for any injury or accident which may occur while my child and I are traveling to or from CTW events, during CTW events, or while I am on the premises of a CTW event. I am also aware of and assume all risks associated with my child’s participating in CTW and CTW’s events. I understand and agree that in consideration of my child’s being permitted to participate in the event, that I, for myself, my child, and my heirs and executors, hereby waive, release, and forever discharge CTW, and its directors, agents, representatives, successors, and assigns, and all other persons associated with CTW and a CTW event, from all liabilities, claims, actions, or damages that I or my child may have against them, arising out of or in any way connected with my child’s participation in CTW. I understand that CTW expressly disclaims all warranties of any kind, express or implied. I acknowledge and agree that I am signing this Agreement and Waiver freely and voluntarily, and intend my acceptance to be a complete and unconditional release of all liability to the greatest extent allowed by law. I further understand that the fee is non-refundable and non-transferable. *

I accept these terms and conditions

Type what you see; we want to make sure you're not spam!

Submit Your RegistrationReset