Name of Participant *

First Name

Last Name

Name of Parent/Guardian if participant is under 18 *

First Name

Last Name

Participant's Birthdate *

MM

DD

YYYY

Which Term of classes are you applying for? Check all that apply. *

8 Week Fall 2025 Term

10 Week Winter/Spring 2026 Term

S.O.D.A. students who have not met with our Faculty previously are required to schedule an appointment prior to classes starting this term, to ensure the class selected fits their needs. Please select one of the following dates: September 10 or September 11

Evening of Wed. September 10

Evening of Thurs. September 11

Phone *

(###)

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone Number *

(###)

###

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Emergency Contact Phone Number (optional)

(###)

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Please read the terms below and check the box to agree. *

I am aware and familiar with the class that I have or my child has enrolled in. I acknowledge that there is a risk of injury when receiving instruction and at the times when I am without instruction. In consideration of the facility and location provided to me/my child, I forever release, discharge, and hold harmless Globus Theatre and any of its employees, representatives, or members from all liability or claim. Medical Emergency: I consent for any employee or representative of Globus Theatre to seek reasonable medical treatment, emergency or otherwise, at any time for me/my child. I agree to be liable for the cost of such treatment. Additional Waiver: I hereby grant Globus Theatre permission to lawfully photograph and/or videotape my child for educational or marketing purposes.

I, the parent/guardian, understand and agree with all the above terms.