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Student Information

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School as of Fall 2020*

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Student Cell (if applicable)

My child has the following activity or medical restrictions. Please elaborate so that we may better meet your child's needs.

Parent/Guardian Information

It is important that we are able to contact you. Please be sure to include all relevant phone numbers.

Parent/Guardian Name*

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Parent Email*

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Cell Phone*

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Parent/Guardian 2 (if applicable)

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Emergency Contact

Please include a contact OTHER THAN family members already listed.

Emergency Contact Name*

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Relationship to student*

Emergency Contact Best Phone*

Please tell us how you learned of Piper's programs

Policies and Waivers

Behavior Policy*

By participating in Piper Theatre’s Programs, you agree to the terms of the Behavior Policy. Piper is committed to ensuring that all participants who attend are provided an atmosphere in which they can learn together free from harassment or intimidation. Fun and safety are only possible when all participants agree to work collaboratively. All participants are expected to show respect for teachers, staff and fellow students. You and your child are advised to inform any member of the staff about any conduct that is offensive or is in contradiction to our commitment to a harassment-free environment.

I have read and agree to the Behavior Policy

Release and Waiver of Liability*

While participating in activities at Piper, each student is assumed to be voluntarily performing activities for which he/she assumes all risk, consequences and potential liability. I hereby release and hold harmless Piper Theatre Productions and the Old Stone House of Brooklyn and its agent or agents from any and all claims arising or resulting directly or indirectly from participation in Piper Theatre activities. I authorize Piper Theatre Productions to take necessary action in case of emergency if I am unable to be reached. In addition, I authorize Piper Theatre Productions and the Old Stone House to use any digital, photograph, analog media in which my child and/or their likeness appears in promotional literature, ads, displays or any format representing the program.

I agree to Waiver

Payment Information

Payment is due upon registration.

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I'd like to apply for financial aid.

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An application will be emailed to you separately. Payment is waived pending award announcements.

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Category: Uncategorized

Piper Inside Online Enrichment – Fall 2020

Fall 2020 Registration

Student Information

Parent/Guardian Information

Emergency Contact

Policies and Waivers

Payment Information