Gold Coast Youth Theatre Academy Online Registration

Registration

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Welcome to Gold Coast Youth Theatre Academy! Please complete the following registration form.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

School*

Grade Level

Any relevant medical info

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

School*

Grade Level

Any relevant medical info

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

School*

Grade Level

Any relevant medical info

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

School*

Grade Level

Any relevant medical info

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

School*

Grade Level

Any relevant medical info

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Release of Liability

I/we realise that participation in Dance and Drama classes could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the student and parent/guardian) assume all risks related to the use of any and all spaces used by The Gold Coast Youth Theatre Academy.

I/we agree to release and hold harmless The Gold Coast Youth Theatre Academy, including its teachers, students, staff members, and facilities used by the Gold Coast Youth Theatre Academy from any cause of action, claims, or demands now and in the future. I/we will not hold Gold Coast Youth Theatre Academy liable for any personal injury or any personal property damage, which may occur on the premises before, during or after workshops. Furthermore, I/we agree to obey the workshop and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Gold Coast Youth Theatre Academy

I understand that The Gold Coast Youth Theatre Academy is an insured business. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our workshop, I/we agree to report the unsafe conduct or conditions to Kellie Rossiter The director of the Gold Coast Youth Theatre Academy

I've read the above and agree.

Payment Policies

Fee's must be paid within 14 days. Late fee of $25 will apply after this time.
Any fees unpaid by week 4 will result in cancellation of classes and debt collection agency assigned.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

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