Palace Youth Theatre Forms

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Palace Youth Theatre Behavioral Guidelines
Please sign and return the Behavioral Guidelines and Parent Handbook to the Palace
Theatre before your first day. We strongly urge you to keep a copy for your own records.
Thank you for your interest in the Palace Theatre’s Youth Programs! As a participant in a
Palace Youth Theatre Program you are a representative of the Palace Theatre and it is
very important that you present yourself accordingly. You will be a role model for other
students in the program and should follow all the rules in this handbook to the best of
your ability. If you see someone not abiding by the rules, please alert a Palace Theatre
employee as soon as possible.
Palace Principles
Treat everyone with respect and consideration while you are at the Palace Theatre. This
includes other students, parents, theatre staff, volunteers, and the general public.
Follow all directions given to you by the theatre staff. This is for YOUR safety.
Keep your language, behavior, and dress appropriate.
We do NOT tolerate discrimination of any kind. We ask students to report any acts of
discrimination or harassment to one of our staff members immediately.
We do NOT tolerate any underage drinking, smoking, drugs, or public displays of
affection while on Palace Theatre property or at Palace Theatre sponsored events.
Anyone caught doing any of the above will be immediately expelled from the production.
Failure to comply with ANY of the principles will result in immediate expulsion.
Costume Guidelines for Performances
All students are responsible for their personal undergarments and hosiery or socks
(boys—black socks; girls—neutral tights). Any student who has a quick change for
his/her role(s) should wear a leotard (girls) or undershirt and shorts (boys)
underneath their costume.
All costumes must be hung up at all times. The only exceptions are costumes involved in
a quick change.
Do NOT eat anything in your costume.
Please respect the space and possessions of others.
Rehearsal & Show Policies
Participants are expected to attend all rehearsals and performances and to be on time. If
you cannot attend for any reason, contact the Director as soon as possible.
Participants are expected to cooperate with the Director, Music Director, Choreographer,
and each other during rehearsals. A positive attitude is a must!
Scripts should be brought to each session and treated with care. They should also be
returned promptly to the Palace Theatre by the final performance date.
Cell phones must remain off during all rehearsals and performances. If it is an
emergency, obtain approval from a Palace Theatre staff member before using your
phone.
Participants must be quiet and professional when backstage during a performance. The
audience may see or hear offstage activity!
Participants are expected to take pride in their rehearsal space by keeping it clean and
neat. This means disposing of all bottles, cans, snacks, etc. after each rehearsal.
Participants are expected to keep a neat and appropriate appearance. SHOES MUST
BE WORN during all rehearsals in studios and onstage – NO Exceptions.
Safety Policy
The Palace is concerned about the safety of ALL and we ask that participants adopt the
“Buddy System.”
NO waiting outside alone for a ride.
NO walking to cars alone.
NO walking from the studios to the theatre unaccompanied.
Participants agree to be aware of the safety of those around them and act as a “Buddy”
when needed or to inform a Palace staff member if a safety issue arises.
I have read and understand the Palace Theatre Youth & Teen Behavioral Guidelines
and agree to conform to the policies contained therein. I understand that failure to do so
will result in disciplinary action and/or my expulsion from the production.
Child’s Signature________________________________
Date: ______________________
Parent/Guardian’s Signature:______________________________
Date: ______________________
Parent Handbook
Thank you for enrolling your son or daughter in the Palace Youth Theatre Program. The
goal of the Palace Theatre is to help these young performers to not only enjoy theatre,
but also to help them learn, perform, and grow. To achieve this, we need the help and
cooperation of all the parents/guardians of the participants. By enrolling your child in a
Palace Theatre Youth program, you are agreeing to abide by the guidelines set forth in
this handbook.
Parent Guidelines
We understand that almost every parent wants their child to be “the star,” but we
encourage parents to remember that the Director has only the highest expectations for
the artistic integrity of the production and is dedicated to providing the best educational
opportunity possible for your son or daughter. One child may be a better fit for a role
than another and those assignments are made only by the Director’s judgment. If you as
a parent have an issue with role assignments or other artistic decisions, we are happy to
listen to your constructive criticisms and request that you take them to the Director or a
Palace Theatre staff member.
The principles set forth in the Behavioral Guidelines apply to the Parent as well as the
child. These include:
Treat everyone with respect and consideration while you are at the Palace Theatre.
Follow all directions given to you by the theatre staff.
Keep your language, behavior, and dress appropriate.
We do NOT tolerate discrimination of any kind.
We do NOT tolerate any underage drinking, smoking, drugs, or public displays of
affection while on Palace Theatre property or at Palace Theatre sponsored events. If
your child is caught doing any of the above, s/he will be immediately expelled from the
production. This is non-negotiable.
The Palace prefers that parents of our students please park and come in to get their
child or wait for them in front of the building. Please help us avoid Palace Youth crossing
Hanover Street unaccompanied.
Always make sure your child has on a leotard (girls) or an undershirt and shorts (boys)
underneath their costume for performances to prevent any accidental exposure during
quick costume changes.
Always check your preferred contact method (voicemail or email), for any updates or last
minute changes. We will contact YOU in the event of a schedule change or update, not
necessarily your child.
Tech Week rehearsals, including dress rehearsal, will be closed to all parents and
friends unless you are the designated chaperone/volunteer for the evening.
Please refrain from giving cash gifts to the Director. If you would like to show your
appreciation for the educational and performance opportunity given to your child, please
consider donating to the Palace Theatre.
I have read and understand the Palace Youth Theatre Behavioral Guidelines and Parent
Handbook. I understand that my or my child’s failure to conform to the policies contained
therein will result in disciplinary action and/or my child’s non-negotiable expulsion from
the program.
Parent/Guardian’s Signature________________________
Date: __________________
Palace Youth Theatre Registration Form
Child Information:
Child Name__________________________________________
Birth Date _____________________
Gender__________ Height _________ Grade ________
Address _________________________________
City_______________________ State_______ Zip___________
Phone Number (
)_____________________
Have you participated in a Palace Youth Theatre Program in the past? _______
If yes, please list up to five: _________________________________________
_______________________________________________________________
Parent/Guardian Information:
Parent/Guardian Name ______________________________
Home Phone (
) _______________
Address______________________________________________________
City_______________________________ State_______ Zip________
Cell Phone (
) ________________ Email_____________________________
Employer__________________________ Occupation__________________
Employer Address_______________________________________________
City_______________________________ State_______
Zip_________________ Work Phone (
)_______________
Work Email_____________________________
Parent/Guardian Name ______________________________
Home Phone (
) _______________
Address (if different) ____________________________________________
City_______________________________ State_______ Zip___________
Cell Phone (
) ________________ Email_____________________________
Employer__________________________ Occupation__________________
Employer Address_______________________________________________
City_______________________________ State_______
Zip_________________ Work Phone (
)_______________
Work Email_____________________________
Primary contact is:____________________
Student Health & Emergency Contact Information
(Must be completed for ALL students participating in Palace Theatre activities)
Student’s Name____________________________________
Birth Date ________________
Address_______________________________________________________
City________________________________ State_______ Zip___________
Student Health History Record
This health history is to be completed and signed by parent/guardian of student.
Part I: Illness and Injuries (Circle all that apply)
Ear infection
Asthma
Seizures
Bleeding/Clotting Disorders
Hypertension
Heart Defect/Disease
Musculoskeletal Disorders
Other (please specify)_________________________________
Date of last health examination________
Were any medical problems noted at this exam? _____
If yes, indicate:_________________________________________________
Part II: Allergies (Circle all that apply and specify nature of allergic reaction)
Animals______________________________
Food________________________________
Plants_______________________________
Hay Fever ____________________________
Pollen_________________________________ Medicine/Drugs________________________
Insect Stings_____________________________
Other (specify) _________________________________
Part III: Other Health Conditions (Circle all that apply)
Diabetes
Fainting
Sickle Cell trait or disease
Constipation
Epileptic
Hearing Implants
Motion Sickness
Glasses or Contacts
Emotional Disturbances
Nosebleed
Special Diet (Specify) ________________
Other (Specify) _______________________________________________________________
Part IV: Daily Medications
List any daily medications_____________________________________________________
________________________________________________________________
Please explain any items that are circled. Indicate any information useful to adult in charge in
relation to any of these health conditions. Also, indicate any activities to be encouraged and
restricted. _____________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
Emergency Contact Information
Contact Name #1___________________ Phone (___)__________ Relationship__________
Contact Name #2___________________ Phone (___)__________ Relationship__________
Family Physician___________________ Phone (___)__________
I know of no reason(s), other than the information indicated on this form, why my son/daughter
_________________ should not participate in any PYT activities except as noted.
Parent/Guardian’s Signature: _______________________________ Date: ______________
WAIVER AND RELEASE BY PARENT OF MINOR CHILD FROM LIABILITY FOR PALACE YOUTH THEATRE
PRODUCTIONS, CAMPS AND CLASSES
For the use of the property, facilities and/or services of the Palace Theatre and including any travel related thereto, the
undersigned agrees as follows:
1. RISK FACTORS. The undersigned understands and acknowledges that the activities of dancing, exercising, sports,
performing and camp activities involve risks which might result from the activity itself or the acts of others risk of property
damage, bodily injury and possibly death.
2. ASSUMPTION OF RISK. The undersigned ASSUMES ALL RISKS WHICH ARE FORSEEABLE AND INVOLVED
WITH OR ARISING FROM THE ACTIVITY, including without limitation those risks described in Section 1 above.
3. SKILLS AND TRAINING. The undersigned acknowledges that the below named minor has the skills, qualification,
physical ability and training necessary to complete such activity. The undersigned agrees that if he or she has any
questions as to what skills, qualifications or training is necessary to properly participate in the activity, then they shall
direct such questions to the Palace Youth Theatre management.
4. RELEASE. The undersigned RELEASES the Palace Theatre, all of their officers, employees and agents (referred to
below as the RELEASED PARTIES) and agrees NOT TO BRING SUIT on account of or in connection with any claims,
causes of action, injuries, damages, cost or expenses (referred to below as “CLAIMS”) arising out of the activity, including
those based on the risks described in Section 1, whether or not caused by the negligence or other fault of the RELEASED
PARTIES.
5. INDEMNIFY AND DEFEND. The undersigned agrees to INDEMNIFY AND DEFEND the RELEASED PARTIES
against, and hold them harmless from any and all CLAIMS, including attorney fees, which in any way arise from the
activity which is the subject of this agreement and which include but are not limited to those risks described in Section 1
including any liability arising from the act or negligent act of the RELEASED PARTIES, the below named minor or anyone
else.
6. PAY. The undersigned agrees to pay for any and all damages to any property of the RELEASED PARTIES caused
negligently, willfully or otherwise.
7. ACKNOWLEDGEMENT. The undersigned has read and understands this agreement and realizes it relates to
releasing valuable legal rights and does so freely and voluntarily.
Name of Minor________________________________________________________
Age _____________
APPROVAL OF PARENT/LEGAL GUARDIAN ON BEHALF OF MINOR
I am the parent and/or legal guardian of the above-named minor. I have read and understand the agreement and realize
the agreement involves releasing valuable legal rights of the minor and myself. I agree to be bound by all of the terms of
the agreement. I also give my consent to the participation in the activity by the minor. I also give my consent for my child
to be included in photographs, videos, slides, and movies taken by the Palace Theatre Staff, students, TV, Radio and/or
other news media. I understand that pictures become property of the Palace Theatre and might appear in promotional
materials and publications.
Signature of Parent/Legal Guardian________________________________________________ Date _____________
PARENT OR LEGAL GUARDIAN EMERGENCY TREAMENT CONESENT
As the parent and/or legal guardian, I agree to the participation by the minor in the subject activity. The undersigned
hereby gives consent to medical treatment of the minor in case of emergency.
Signature of Parent/Legal Guardian_________________________________________________ Date _____________
Photo Release Form
I give my permission to the Palace Theatre to take photographs or videos of my
child, ________________, for the purpose of promoting the production(s) or
activities in which s/he is participating.
I release the Palace Theatre from any and all claims I may have to the
photographs/videos and how they are used, as well as any other rights the minor
or I may have in respect to the photographs/videos.
I, ___________________, certify that I am over the age of 18, and am legally
able to contract for the minor listed above. I have read and understand this
document and agree to abide by this contract.
Parent/Guardian’s Signature___________________________ Date: _________
Parent’s Name ____________________________
Home Phone (
) _________________ Cell Phone (
) ________________
Address___________________________________________
City______________________ State_______ Zip_________________
Email_______________________________
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