Write Your Heart Out February Registration Form
Use this form to register for February 2023 Write Your Heart Out, the Bus Stop Theatre's Youth Writers Circle! Dates are Thursdays February 2nd, 9th, 16th, 23rd from 3:45-5:45pm at the Maitland Street entrance.

Each week will have a different style of writing to explore: fiction and storytelling, poetry, comics and non-fiction. Topics are open to what each participant is most interested in exploring within those styles of writing, with age-appropriate prompts from the instructors to get imagination's going.

We will have two instructors present incase of wide age gaps in the students, and can break off into smaller groups if needed. Participants will have the opportunity to share their work, but will never be pressured to do so.

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Name *
Pronouns  *
Age and Grade *
Age and Grade *
Email *
Parent/Guardian Name *
Parent/Guardian Phone Number *
Tell us a bit about your creative side! What do you love to read? What forms and genres are you most interesting exploring through writing?  *
Do you have any access requirements you would like us to be aware of? 
Do you have any allergies? 
*PARENT/GUARDIAN* Liability Waiver: I give my approval for my child to participate in activities at the Bus Stop Theatre, I hereby release the Bus Stop Theatre Co-op, all program staff and/or any other persons involved with the direction and organization of the Bus Stop Theatre Co-op, from all claims for damages arising from accidents or injuries which are caused by or arise from participation of my child, named on this form, in any facility or at any facility where the Bus Stop Theatre Co-op activities are being held. I authorize that the facilitators act for me according to their best judgement in any emergency requiring medical attention. I also give permission for my child to be transported to the physician’s office or the hospital, with no liability on the driver's part. An ambulance may be called to transport my child to the hospital if required. In signing this application, I hereby acknowledge that I have read and understood the conditions.
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*Photo/Video Release* I, the undersigned, give permission to the Bus Stop Theatre Co-op, to photograph/video my child, and use such photograph(s)/video(s) in all forms of media, for any and all promotional purposes including advertising, display, audiovisual, exhibition or editorial use. I certify that I have read and fully understand this consent and release, and that all questions pertaining to this consent have been answered to my satisfaction.
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Parent/Guardian, Please write your name below as your digital signature:

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