TRI-VALLEY YOUNG PERFORMERS
Option 1) (June 15 – June 26) OR (July 20 – July 31)
Classes in acting, singing and dance plus recital .......................$350____
Option 2) (June 25 – July 11) OR (July 30 – Aug. 15)
Rehearsal and 2 performances of Seussical, Jr. .....................$400____
Option 3) (June 15 – July 11) OR July 20 – Aug. 15)
Classes, recital and 2 performances of Seussical Jr......................$650____
How did you hear about us?___________________________________________
Student Name_____________________________________________________________
Phone #___________________Email__________________________________
Address __________________________________________________________
City & Zip_________________________________________________________
Age _____Birthday _______________School ____________________________
Parent/Guardian__________________________________________________
Email _______________________________________Cell#_________________
In an emergency, if the parent/guardian is not available, contact:
(These people have my permission to pick up my child)
Name Phone# Relationship
_______________________________________________________________________
_______________________________________________________________________
I give permission for my child, named above, to participate in this program with Tri-Valley Young Performers Academy (TVYPA). I agree to indemnify and hold TVYPA, it's officers, employees, volunteers, any non-profit organization assisting, and agents from any and all liability for any injury to person or property arising out of or in any way connected with participation in this program including injury caused by simple negligence. I understand that agents, employees or representatives of TVYPA may take photographs and/or videos of my child. I give permission for TVYPA to copy, exhibit, publish or distribute any and all such images of my child, for purposes of publicizing TVYPA or for any other lawful purpose.
Refund and Cancellation Policy-All cancellations made up to 10 days prior to the 2nd class meeting will receive an 80% refund. No refunds will be made after the second-class meeting.
Parent/Guardian Signature__________________________________________
Relationship__________________________ Date__________________________
Mail Completed Registration plus a check payable to TVYPA:
Tri-Valley Young Performers Academy c/o Brian Olkowski
1436 Waterstone Place, San Ramon, CA 94582
Or Email registration form (word document above) to info@TriValleyYPA.org