The Scissortail Children’s Theatre Company
The Wind in the Willows, by Moses Goldberg
Name:__________________________Date of Birth:___/___/___ Age:____
Home Phone:_________________Parent Work Phone:_________________
Student Cell:____________________Parent Cell Phone:________________
Please read the Key Dates Calendar carefully and list conflicts on the Calendar.
For Parents and Guardians:
I understand that my child must be at all rehearsals and must be present for all performances.
I understand that I will be asked to volunteer for this production. I may be asked to provide certain items my child may need for this production, including, but not limited to, makeup and costume elements.
My signature grants permission to The Scissortail Children’s Theatre Company (SCTC) to use my child’s photograph, likeness and/or voice to promote SCTC programs. I release SCTC and any of its employees or agents, from any damages in using my child’s photograph, likeness and/or voice in perpetuity.
I certify that I am of full legal capacity to execute the above authorization and release.
List Top Three Experiences:
SHOW TITLE ROLE OR DUTY
3. Musical talent (Specify)
6. Other (Specify)