Registration Form – Adult

* Required fields

Programs* Please click all programs that you are registering for
All programs are held at Parkdale Community Centre (3512 5 Ave. N.W.)
Option 1 - Commedia dell' Arte (Sundays, 6:00-9:00pm from Oct. 20-Dec. 8, 2019) Discount = $210/player or Regular = $240/player

Participant Name*

Birthdate*

Medical Conditions / Special Needs* YesNo

If yes, please specify

Phone*

Your Email*

Address*

Postal Code*

In case of emergency contact:

Name*

Phone*

Relationship*

Confidentiality

All information contained in this form will be kept confidential and not released to any other organization.

Refund Policy

In order to receive a refund for withdrawal from a program, Theatre A Go-Go (hereafter referred to as T.A.G.G.) must be notified a minimum of ten business days prior to the commencement of program start date. After this, no refunds will be given. A $25.00 administration fee will be deducted from refund for withdrawal from program. Classes will not be prorated for participant absences. In the event that a program does not fill its minimum enrollment requirement, T.A.G.G. reserves the right to cancel the program up to the week prior to commencement and a full refund will be returned.

Photo/Video/Media Release

I hereby grant Theatre A Go-Go permission to use photographic/video images taken of myself, in connection with Theatre A Go-Go for marketing, promotion and fund development purposes. Theatre A Go-Go shall have all rights and interests to the images and the copyrights thereto, free and clear of all encumbrances.

Consent

I acknowledge that as a participant in programs with T.A.G.G., that the choice to participate brings with it the assumption of those risks and results that are part of these activities. I agree to release and hold harmless Theatre A Go-Go, their trustees, officers, directors, employees, and agents from and against all claims for damages to my personal property or bodily injuries arising out of my participation in these activities. I have provided T.A.G.G. with all the necessary medical information and I authorize T.A.G.G to administer First Aid and to secure medical care in an emergency as deemed appropriate by the attending physician/s.

How did you hear about us?*

Payment
Payment holds your spot in the Class and is to be submitted with registration. You may either pay with a Credit Card or ETransfer. Please note that if you pay with Credit Card, you will be charged an extra $10 service fee, per registration. Please let us know how you would like to submit payment. * Credit CardETransfer
You will receive further direction for payment after submitting this form.

I* (Name of registrant) have read and understand the terms of registration and payment for these classes.

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