Complete this registration form to register for a class at Portland Stage.
Caregiver First Name
*
Caregiver Last Name
*
Email
*
Phone number
*
Student 1 - name
*
Student 1 - date of birth
*
---
January
February
March
April
May
June
July
August
September
October
November
December
---
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
---
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Student 1 - grade level Fall 2023
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Does your student(s) have any allergies or other health concerns that our education staff should be aware of? If so, please list them below.
Anything else you would like for us to know about your student
Allow PS to us my childs photo video audio
Yes, can use in marketing
No, do not use in marketing
Release Part 1
*
I understand these activities may include certain risks including, but in no way limited to: (1) moderate & severe personal injury, (2) property damage, (3) disability, (4) death, & (5) sickness or disease including, without limitation, COVID-19.
Release Part 2
*
I specifically release Education, its owners, directors, employees, & volunteers from any claim of any kind arising from my studentâs participation in the Education program.
Behavior Policy
BEHAVIOR POLICY: We are committed to working with students, parents, and guardians to ensure everyone has a positive experience at Portland Stage. Each student is expected to engage with others in a safe and respectful manner to help everyone achieve the best possible experience. If our Teaching Artists or Staff have a concern regarding a camperâs behavior, our policy is: 1. Teachers/Staff will redirect the student to more appropriate behavior. 2. If inappropriate behavior continues, the student will be reminded of the camp expectations and behavior guidelines. Together, the student & teachers/staff will decide on action steps to correct the behavior. 3. If disruptive behavior continues and/or is affecting the safety or well-being of others, Education staff will contact the parents or guardians. 4. If inappropriate behavior continues, as a final action step, the student may be dismissed from camp. (Please note â Student fees are non-refundable if a student is sent home for disciplinary reasons). I have read and agree to the Behavioral Dismissal policy. If you have any questions, please contact education@portlandstage.org
*
*
= required field