Marin Shakespeare Company Student Waiver
EMERGENCY INFORMATION
FORM
Student’s Name________________________________
Address________________________________
City________________________________ State_________Zip_____________
Father or Guardian’s Name________________________________
Day Phone__________________________________
Night Phone________________________________
Mother or Second Guardian’s Name________________________________
Day Phone________________________________
Night Phone________________________________
Emergency Contact________________________________
Day Phone________________________________
Night Phone________________________________
Does the student have any medical conditions
that we should be aware of?
Will the student be taking any medication during
class time?
INJURY AND
ILLNESS POLICY
Marin Shakespeare Company shall endeavor to
create a safe and healthy environment
for all students. All students enrolled in any
Marin Shakespeare Company’s program or
class are responsible for their own actions,
and for their own health and safety.
Each student and parent or guardian agrees to
the following: Marin Shakespeare Company shall
not be liable or responsible to the Student
or any other person for any damages or injuries
whatsoever suffered by the Student in connection
with any class work or other activities performed;
furthermore, any damages caused by the Student
shall be the sole responsibility of the Student
and the Student shall expressly indemnify and
hold harmless and defend Marin Shakespeare Company
from and against any and all resulting claims,
actions or damages of whatever nature. Any dispute,
action or controversy shall be resolved
by arbitration pursuant to terms established
by the American Arbitration Association.
REFUND POLICY
We understand that your schedule may change
or that you may decide this class does not meet
your present needs. If for any reason you decide
to withdraw from a session prior to the second
day of class, Marin Shakespeare Company will
refund your tuition minus a $25 non-refundable
processing fee. After the second day of class,
there will be no refunds. We reserve the right
to cancel any class that does not meet its minimum
enrollment; in the event that Marin Shakespeare
Company cancels a session, your entire tuition
will be refunded.
Parent or Guardian
Signature________________________________
Date________________________________
Marin Shakespeare Company
P.O. Box 4053, San Rafael, CA 94913
Phone: 415-499-4485 Fax: 415-499-1492
education@marinShakespeare.org
PLEASE COMPLETE, SIGN AND RETURN BY
THE FIRST CLASS.
|
