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Muncie Civic Youth Registration Form - Formstack

Muncie Civic Youth Education Theatre Registration

Please fill out all the fields below completely. After registration, you will be sent an email with more information about scholarships and payment. 

Student Name (Please use your child’s preferred name. This is the name we will use on nametags, programs, and other publications)*
(This information helps us prepare materials for auditions.)
Student Picture*
No File Chosen
File uploads may not work on some mobile devices.
Please upload a recent headshot of your child
First & Last Name
This email will be used for all Civic communication, please make sure it is one you check often
This email will be used for all Civic communication, please make sure it is one you check often

Medical Information

Inclusion Information

Media Release Statement

As a non-profit community theatre, we rely on social media and other marketing materials to share the great things our program is doing in the community. Please let the education director know if you want your child to opt out of any marketing materials social media.*

Demographic - Information

Muncie Civic Theatre's Youth Education program is significantly funded through grants.  Consider providing your information here, so that the theatre may provide accurate information to those providing funds.  This information will be used solely for grant writing purposes and will not be shared with our theatre volunteers.


By participating in this production during a time of a declared national health emergency, I fully understand the risks of possible exposure to the novel Coronavirus known as COVID-19.  In full knowledge of this possibility and the potential severity of symptoms and effects of this disease, including but not limited to the possibility of death or lifelong health consequences, loss of work or freedom of movement due to quarantine, I am electing to participate in the above selected production and assuming these risks.  Having voluntarily assumed this risk, I hereby waive my rights to any and all claims I may have now or in the future against Muncie Civic Theatre, its Board, employees, and agents related to exposure to COVID-19.

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