Theater Games

Name of Participant*

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Participant Birthday*

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Participant Current Grade*

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Please confirm which class your child will attend*

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Name of Parent/Guardian*

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Address*

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Parent/Guardian Contact Number*

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Emergency Contact Name + Phone Number*

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Relationship to Child*

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Alternate Emergency Name + Phone number

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Allergies/Dietary Restrictions

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Accessibility Needs

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My child has permission to be included in photographs and video taken by Starr Kids facilitators for the purposes of documentation and promotion.*

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