REGISTRATION FORMS
 
ACTOR(S) INFORMATION
NAME M F DOB AGE
NAME M F DOB AGE
NAME M F DOB AGE
NAME M F DOB AGE
PARENTS INFORMATION
FIRST NAME
LAST NAME
ADDRESS
ADDRESS 2
CITY
STATE/PROVINCE
POSTAL CODE
EMAIL
HOME PHONE
WORK PHONE
CELL PHONE
FAX
JUST FOR OUR INFORMATION
WHAT'S YOUR PRIMARY PUPOSE FOR ATTENDING THE FILM & TV ACADEMY?
PERSONAL DEVELOPMENT MODELING/COMMERCIAL/TV/MOVIES OTHER
DOES YOUR CHILD HAVE AN AGENT? AGENCY NAME
VIDEO & PHOTO RELEASE UNDERSTANDING
I hereby irrevocably consent to and authorize the use and reproduction by the On Camera Acting Film & TV Academy, to utlize all photos and/or videos which have been taken of my child(ren) in seminars or workshops for promotional purpose of the school (such as the newsletter, website, etc.) without compensation to me. I agree that videos or photos are the sole and complete property of On Camera Acting Film & TV Academy.
SIGNATURE:
 
DATE:
EMERGENCY INFORMATION
CONTACT NAME
ADDRESS
HOME PHONE
WORK PHONE
CELL PHONE
PHYSICIAN NAME
PHYSICIAN PHONE
1. In the event you can't be reached do you give permission for OCA authorities to obtain
medical aids or ambulance services at your own expense? Yes No
2. If NO, what do you want OCA authorities to do?
 
REGISTRATION INFORMATION

ACADEMY MEMBERSHIP:  One-month membership registration required and non-refundable deposit for each actor.
$
DATE TO BEGIN:

HOLLYWOOD SPECIALIST REHEARSALS:  One-month registration required and non-refundable deposit for each actor.
$
DATE TO BEGIN:
TOTAL PAYMENT PER MONTH:
$
PAYMENT METHOD
VISA* MASTER CARD* CASH PERSONAL CHECK** CHECK #:.
CARD NUMBER: EXP. DATE: 3 DIGIT CODE:
CHARGE SIGNATURE:
 
DATE:
I agree to pay above amount according to card issuer agreement (Merchant Agreement if Credit Voucher) monthly for a term of 6 months from this date and this is deemed the anniversary date. I acknowledge this payment is transferable and non-refundable. In the case of any missed payment I will be given 30 days to provide such payment. This agreement shall renew automatically on the anniversary date thereafter if written cancellation is not provided within 30 days of the anniversary date.
SEMINARS/WORKSHOP SERIES:  
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
SEMINARS/WORKSHOP SERIES:  
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
SEMINARS/WORKSHOP SERIES:  
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
SEMINARS/WORKSHOP SERIES:
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
FILM & TV ACTING COURSE:
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
FILM & TV ACTING COURSE:
LOS ANGELES LAS VEGAS SAN FRANCISCO MARIN CNTY EAST BAY
DATE: $
PAYMENT METHOD
VISA* MASTER CARD* CASH PERSONAL CHECK** CHECK #:.
CARD NUMBER: EXP. DATE: 3 DIGIT CODE:
CHARGE SIGNATURE:
 
DATE:
I agree to pay above amount according to card issuer agreement (Merchant Agreement if Credit Voucher) monthly for a term of 6 months from this date and this is deemed the anniversary date. I acknowledge this payment is transferable and non-refundable. In the case of any missed payment I will be given 30 days to provide such payment. This agreement shall renew automatically on the anniversary date thereafter if written cancellation is not provided within 30 days of the anniversary date.

I VERIFY THAT ALL INFORMATION ON THIS FORM IS CORRECT
SIGNATURE:
 
DATE:
Questions: Email Customer Service: customerservice@oncameraacting.org