Volunteer Liability Release and Behavior Agreement 0% Complete1 of 3 Participant's Name * Participant's Name Preferred First Name Preferred First Name Preferred Last Name Preferred Last Name Participant's Legal Name (if different) Participant's Legal Name (if different) Legal First Name Legal First Name Legal Last Name Legal Last Name Participant Role * Cast/Crew of The Addams FamilyLobby VolunteerTITG Board MemberYoung at Heart Senior Readers TheatreOther Participant Role Participant's Address * Participant's Address Participant's Address Participant's Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Participant's Address Participant's Email * Participant's Phone * Minor? * Yes No Is the participant a minor? Minor Information Stop! Because this participant is a minor, their legal guardian must complete the remainder of this form on their behalf. Participant's Date of Birth * Legal Guardian Name * Legal Guardian Name First Name First Name Last Name Last Name Legal Guardian Email * Legal Guardian Phone * Pickup Authorization Please list the names of persons authorized to pick up your child. If none are listed here, then the legal guardian listed previously is the only person able to pick up your child. Self Transport * NoYes My child has my permission to transport themselves to/from the theatre. Minor Medical Consent * NoYes I, as parent/guardian of said minor, do hereby authorize Theatre in the Grove to consent to emergency medical or dental examination, treatments, etc to be administered to the same in the event of an accident or sudden illness during Theatre in the Grove programs. If you are human, leave this field blank. Next
