Theatre School Registration Use this form for registering all students for Theatre Classes. Please fill out this form AFTER you have made payment through our online ticketing system by clicking here. Class*PA Day Program (6-12)Junior Youth Camp (6-8)Intermediate Youth Camp (9-12)Teen Camp (13-18)Camp Francais (6-12)Have you paid for your course online through our website?*YesNo, I will call or visit the box office. I understand that my spot will not be held until payment is made.Date of PA DayList the PA Day you are requesting.Student Name*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Email Address*Please include your email addressOntario Health Card NumberEvery effort will be made to contact parents/guardians and/or emergency contact in the event of an injury or illness. Please ensure that your emergency contact information is correct.Parent/Guardian NameApplicable for all students under the age of 18.Parent/Guardian That Will Pick Student Up:Required if student is under age 13. Please notify us here if student will be allowed to walk home alone. Allergies/Medical ConditionsPlease list any medical conditions or allergies that we should know about.Emergency Contact Name*Emergency Contact Relationship to Student*Emergency Contact Phone Number*Publicity Waiver*Pictures or recordings may be made of classes, rehearsals or performances for archival and promotional purposes. These may be used in local media (Thunder Bay Television, The Chronicle Journal, etc.) or Magnus Theatre publicity (including our website and print advertising). Every student’s name will accompany their image whenever possible. There will be no monetary compensation for the use of any student’s image. The created media are the property of Magnus Theatre, or the agent making the recording. YesNoTerms & Conditions*Your application will be processed once the form is complete and payment in full has been received. The student's spot in the selected class is not guaranteed until we have received both this form and payment. The total cost includes a 25% administration fee. If the student should choose not to participate, the administration portion of the class fee is non-refundable. Within 2 weeks of the first day of the class, fees become 100% non-refundable. I have read and agreed with the above statement. I Agree Magnus NewsletterFrom time to time, Magnus Theatre sends out information about shows, promotions and special events. You are under no obligation to join our mailing list. Would you like to receive our newsletter?YesNo This iframe contains the logic required to handle Ajax powered Gravity Forms.