Designate up to two legal parent/guardians.

At the end of class, your child will be released to the primary and secondary parent/legal guardian listed above. Identify the names of alternate adults authorized to pick-up your child after class and a phone number where they can be reached, if they are late.

If your child is age 13+, you may authorize the Fulton teaching artist to dismiss your child at the end of class without the presence of their adult guardian.

In the event of an emergency, Fulton staff will contact the primary or secondary parent/legal guardians listed at the top of this form. If unable to reach either party, please list any alternate contacts you wish us to call.

I understand that photos or videos of students may be taken during classes for such purposes as publicity, illustration, advertising, and Web content.

We are please that you have chosen to take lessons as part of our group instruction program. Sometimes our students and/or their parents decide on their own to pursue private performance instruction with one or more members of the Fulton Theatre staff outside of the Fulton Theatre’s formal group performance instruction program. In signing this Acknowledgement, you understand and agree that your decision to pursue private instruction independent of the Fulton Theatre’s group performance instruction program is a voluntary decision that is not under the endorsement, supervision or management of the Fulton Theatre. The Fulton Theatre disclaims any responsibility for a student’s decision to undertake private instruction. As a participant, you agree to hold Fulton Theatre and it’s foundations and affiliates, as well as each of the foregoing’s management, officers, directors and insurers, harmless from any and all liability rising from your decision to participate in private performance instruction with a member of the Fulton Theatre’s staff outside of the group performance instruction program.

Fulton’s Academy of Theatre encourages children of all abilities to participate in the theatre arts. Through open communication with parents and teachers, appropriate supports that are within our resources provide each student the most successful environment. If your child has a medical condition or learning challenge that you can report to our professional teaching artist, please detail it here. This information will be strictly confidential, and used so that we can best meet your child’s individual needs. A Fulton staff person may contact you prior to the first day of class to discuss your child based on the information you share.