Theatre Honors Program Permission Agreement

Please complete this form only after your child has been accepted to the program.

Parent / Guardian Information

Indicate any permanent or temporary conditions that should be known about your child.

In an emergency I may be contacted at:

Name*

Phone* (primary)

Phone (secondary)

Email Address

Student Information

Name*

Address 1*

Address 2

City*

State*

ZIP*

Phone

Phone (Mobile)

Email Address

Agreements

Parent / Guardian: I hereby give permission for my daughter to participate in the Russell Sage College Theatre Honors Event on Saturday, January 20, 2024 and agree not to hold the College responsible for any injuries and/or illnesses incurred on this trip.

Parent / Guardian: I agree that in the event of an injury that the chaperone in charge of this campus visitation may act on my behalf in obtaining medical treatment for my child.

Student: I agree to comply with Russell Sage College Policies and Procedures.