Make-Up Pre-Registration

Click here for a printable form

Last Name: First Name: Middle Initial:

Permanent Address:

City: Province: Postal Code:

D.O.B.: (m)(d)(yr)     Age:

Home Tel: Cell/Pager:

Work: Email:

Medical & Allergy Alert - Health Card #:

Please list any medical or allergy information that we should know:

Have you previously taken an A.C.T. course? Yes / No

How did you hear about A.C.T?

If "Other", please specify:

ACT Permission & Photo Permission

In consideration of A.C.T. accepting me, , in the course noted below, I and my heirs do voluntarily waive and release each and every right or claim for damages we and each of us have or may have against the school, its agents or representatives for any and all injuries or mishaps howsoever occasioned.

I give permission for the use of photographs that may be taken during the workshop or other activities related to A.C.T. to be used by A.C.T. in promotional material for the school.  I understand that there will be no financial renumeration for the use of any photograph.

Name: Date:

Please check which course you would like to take:

Make-Up for on-camera Auditions - Saturday, July 12 & Sunday July 13 (1:30PM-4:00PM)

This  workshop will take place at Barrett Palmer Models International Inc. - 410 Queen St.

Payment Options

AI will send a current cheque of $125.00 for full payment.

BI will send a current cheque in the amount of $62.50 to reserve my spot, together with my cheque in the balance of $62.50 (dated no later than July 10, 2003).

Before you click the SUBMIT button below, please print this page and mail a copy with your cheque(s) payable to:  A.C.T.

Send your printed copy and cheque(s) to:

A.C.T. RE: Make-Up Workshop 2 Daly Ave. Ottawa, Ontario K1N 6E2

Pre-Registration Forms will be held for one week. If no payment is received within 7 days, your Pre-Registration will become void.

REFUND POLICY:

If you are unable to attend due to illness, we will accept a medical letter no later than one week before the course begins.  A refund minus an administration fee will be given at that time.

Please note that participating in this workshop does in no way guarantee talent representation or any performance related work to the participant.