First Cast Meeting

Medical Release OPTIONAL

Medical Release *OPTIONAL*

Medical Release OPTIONAL

Name: First Cast Meeting
Start: 2021-09-27T18:00:00-04:00
End: 2021-09-27T20:00:00-04:00

Medical information requested in this form is not required for participation with Primary Players. We DO need this form signed by a parent, however. If you decide not to share this medical information, please sign a blank Medical Release form at rehearsal.

Student Name*
First Middle Last
Emergency Contact:*
Relationship
Phone
Allergies
Current Medications
Previous Surgeries
Insurance Carrier*
Family Doctor*
Employer
Employer's Address
Street Address Address Line 2 City State ZIP Code
I hereby authorize Primary Players Children's Theatre Group to call 9-1-1 or to arrange for transportation to the nearest hospital in the event of a major injury.*
- I Agree
Parent Signature

By typing your name here, you authorize the above information to be correct.
Name
This field is for validation purposes and should be left unchanged.

Events Calendar

Mon 27

September 27 @ 6:00 pm - 8:00 pm

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