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You have been accepted into a theatre program through Peter and Paul's Place. Below, you will find a Media Release statement, a Liability Waiver and a way to pay for the class/classes.

Student Information

*

If the contact for transportation is not already provided, please provide the information here.

MEDIA RELEASE:


The undersigned authorizes Peter & Paul’s Place, Inc. and/or its associates, assistants, or subcontractors to photograph/film the subject. The undersigned authorizes Peter & Paul’s Place, Inc. to use and/or display the subject’s image in publications, multimedia productions, displays, advertisements, or worldwide web publications promoting the programs and services of Peter & Paul’s Place, Inc..    


The undersigned agrees that this authorization not only includes the subject’s likeness but may also include the subject’s name and/or their biographical information, as supplied to Peter & Paul’s Place, Inc. by the subject.    


The undersigned understands that no compensation is offered in exchange for the use of the subject’s image and/or the subject’s biographical information.    


The undersigned releases and discharges Peter & Paul’s Place, Inc., its officers, and employees from any and all past, present or future claims and demands arising out of or in connection with the use of said photograph, name or biographical information, including but not limited to, claims for invasion of privacy or defamation.

Typing your name below will be the same as if you signed your name accepting the Media Release requirements.

*

LIABILITY WAIVER:


As a participant in programs/activities with Peter & Paul’s Place, Inc., I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that I may sustain as a result of said participation. I do hereby fully release and forever discharge Peter & Paul’s Place, Inc. from any and all claims for injuries, damages, or loss that I may have or which may accrue to me and arising out of, connected with, or in any way associated with my participation.

Typing your name below is as if you signed this statement accepting the requirements of the Liability Waiver.

*

Payment for the summer class should be received my June 1st. If payment is not received by this date, your place in the class will be released and offered to the next person on the waiting list. Students in the Fall class have a payment deadline of August 1st.

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Contact us
  • Mail: PO Box 2203 Tucker, GA 30085
  • Email: charlotteandlois@peterandpaulsplace.org
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Peter & Paul’s Place, Inc. is a 501c3 non-profit,   EIN: 82-4042647

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