ACME CLOWN CLASSES
Registration Form:

Please print this form, fill it out completely, and the return it to:

Clown Classes
Greenbelt Arts Center
P.O. Box 293,
Greenbelt, MD 20768.

Questions? Visit our website at www.greenbelt.com/artscenter.

or call us: Phone: 301-441-8770. Email: artscenter@greenbelt.com


Parade Theatre # of Students________ X $90 = ________

TUESDAYS 3:00-5:00 --Ages 9-12

STUDENT NAME(S)

AGE(s)

________________________________

_____________________

________________________________

_____________________


Clowning and Physical Comedy # of Students________ X $90 = ________

WEDNESDAYS 3:00-5:00 --Ages 10-14

STUDENT NAME(S)

AGE(s)

________________________________

_____________________

________________________________

_____________________


Teen Street Theatre # of Students________ X $90 = ________

THURSDAYS 4:30-6:30 --Ages 13-18

 

STUDENT NAME(S)

AGE(s)

________________________________

_____________________

________________________________

_____________________

MASTER CLASS FOR ACTORS # of Students________ X $200=________

CLOWN INTENSIVE

MAY 7-MAY 11 10:00 AM &endash;1:00 PM EACH DAY

Maximum 8 students COST $200

STUDENT NAME(S)

AGE(s)

________________________________

_____________________

________________________________

_____________________

 

Total Due $_____________

Please pay with check or money order payable to The Greenbelt Arts Center

Information:

(If student(s) is(are) under 18 years of age, the following should be the parent/guardian information)

Name: ___________________________________

Address: _________________________________

City, State, Zip: ____________________________

Phone Number:____________________________

RELEASE AGREEMENT

Although every effort is made to provide a safe environment, I recognize there is always a risk of accident. I agree to be responsible for any medical bills incurred resulting from illness or injury during my or my child's participation at GAC. Students are expected to carry their own accident and medical insurance. I release GAC from any and all liability and/or claims or damages arising out of personal injury of any kind. If necessary, I authorize the Greenbelt Arts Center (GAC) to administer first aid and/or authorize medical treatment for me or my child.

 

I have read and accept all of GAC's policies and the release agreement.

____________________________

Signature (of Parent or Guardian if Student is under 18)