Young Actors' Theatre Participation Agreement and Waiver of Liability
This form is intended to be completed by all participants of Young Actors' Theatre including all cast, crew, volunteers, campers and class attendees.  This form MUST be completed before attending any of our programs 
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Email *
Participant Information: 
Please complete this for every member of your family whether you are a cast member, crew member, parent volunteer, etc. This form allows you to add in four participants, but if you need to add in additional participants please reach out to frontdesk@yatsandiego.org
Participant #1 Full Name  *
Participant #1 Age if under 18 (If over 18, please write adult) *
Participant #2 Full Name 
Participant #2 Age if under 18 (If over 18, please write adult) *
Participant #3 Full Name 
Participant #3 Age if under 18 (If over 18, please write adult)
Participant #4 Full Name 
Participant #4 Age if under 18 (If over 18, please write adult)
Name of Parent/Guardian (if participant is under 18) *
Phone Number of Parent/Guardian (if participant is under 18) *
Emergency Contact #2 Name  *
Emergency Contact #2 Relationship  *
Emergency Contact #2 Phone Number  *
Emergency Contact #3 Name
Emergency Contact #3 Relationship 
Clear selection
Emergency Contact #3 Phone Number 
Do you have any known allergies / medical conditions YAT should be aware?  If yes, please detail below including what YAT's response should be i.e. epi-pens, medication, etc.  *
Health Insurance Company Name
Health Insurance Policy Number 
I declare that participant is in good health and fully able to participate in all activities. I hereby agree to release, defend, indemnify, and hold harmless Young Actors' Theatre and its board of directors, employees, volunteers, agents, and representatives from any and all liabilities, causes of action, lawsuits, claims, demands or damages of any kind whatsoever that I, my assignees, heirs, guardians, next of kin, spouse, and legal representatives now have, or may have in the future, for injury, death or property damage related to my participation in activities at Young Actors' Theatre. *
Required
I acknowledge that participation in the activity involves certain risks and hazards of injury. Should I be injured during participation in the above-mentioned activity, my permission is given to provide emergency first aid. If professional medical treatment is required, I will be fully responsible for any expenses incurred. Individuals will not be transported to a medical facility by a Young Actors' Theatre representative under any circumstances.  *
Required
I hereby attest my/my child's involvement in this activity is voluntary and that I have read (or have had read to me) this release, understand it, and complete it voluntarily. Please sign your name below.  *
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