Education Play Document

EDUCATION PLAY DOCUMENT

School Name:    Production Title:
Performance Dates: From through .

Student Information

Student Full Name

Date of Birth:    Student ID:    Grade / Program:

Parent / Guardian Information

Parent / Guardian Name

Relationship to Student

Primary Phone:    Secondary Phone:

Address

Production Participation Details

Requested Role / Participation

Rehearsal Schedule (days & times)

Mandatory Dress Rehearsal Date:    Location:

Production Fee (if applicable): $    Payment Plan Requested: Yes

Medical / Emergency Information

Emergency Contact (if different from guardian)

Emergency Contact Phone:    Student Physician:

Medical Conditions / Allergies / Medications

Transportation Consent

I authorize the following transportation for rehearsals and performances (select all that apply):
Student may walk home after rehearsal/performance
Guardian will pick up student
School-provided transportation
Third-party transportation (specify):

Media Release

I grant permission for the school and its authorized representatives to photograph, audio-record, and/or video-record the student during rehearsals and performances and to use such media for educational, promotional, or archival purposes. I understand that the school may use the material in print and electronic media without further notice or compensation.

I consent to media use.
I do not consent to media use.

Assumption of Risk, Release and Indemnity

By signing this Education Play Document, I acknowledge that participation in theatrical rehearsals and performances carries inherent risks, including but not limited to physical injury, property damage, and exposure to communicable illness. I knowingly and voluntarily assume all such risks on behalf of the student.

I hereby release and discharge the school, its board members, employees, volunteers, agents, and affiliated organizations from any and all claims, demands, causes of action, liabilities, costs and expenses, including attorney fees, arising out of or related to the student's participation, including travel to and from events, except for claims arising from the gross negligence or willful misconduct of the released parties.

I agree to indemnify and hold harmless the released parties from any loss, liability, damage or cost they may incur due to the student's participation, whether caused by the negligence of the student, guardian, or third parties, except as limited by applicable law.

Standards of Conduct & Removal Policy

The student must comply with all school policies, rehearsal and performance rules, and direction from staff. The school reserves the right to remove the student from participation for violation of rules, unsafe behavior, or failure to meet rehearsal obligations. Removal may be temporary or permanent and may result in partial or forfeited fees at the school's discretion.

By checking the box below, I acknowledge I have reviewed the conduct standards and accept removal provisions: I acknowledge and accept.

Refund and Cost Recovery Policy

Any fee refunds are governed by school policy. Costs incurred for costumes, sets, or third-party rentals may be non-refundable. The guardian agrees to be responsible for reasonable costs for damage to school property caused by the student through negligence or misconduct.

Acknowledgment and Certification

I certify that the information provided in this document is true and accurate to the best of my knowledge. I understand that falsification of medical information or emergency contacts may jeopardize the student's participation.

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