Private Acting Instruction
 Pre-Registration

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 - 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?

Please specify:

 

Please specify what you wish to work on during your private session (s):

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 fill out the required date/time info below:

Private Acting Instruction -
Date/Time 1:
Date/Time 2:
Date/Time 3:
Date/Time 4:
Date/Time 5:
Date/Time 6: 
Date/Time7:
Date/Time 8:
Date/Time 9:
Date/Time 10:
            
Sessions can be scheduled for 1-3hrs. at a time, or more if it's for a longer audition.

Unless otherwise notified, the private session will take place at 798 High St.
(off Pinecrest Exit, corner of Carling & High)

Payment Options

AI will send a current cheque of $52.50 ($50.00 + GST) in full payment for a 1hr. session

BI will send a current cheque in the amount of $105.00 ($100.00 + GST) for 2 x 1hr. sessions.

CI will send a current cheque in the amount of $472.50.00 ($450.00 + GST) for 10 x 1hr. sessions.

Send your printed copy and cheque(s) to:

A.C.T. | RE: Private Acting Instruction | 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 private session does in no way guarantee talent representation or any performance related work to the participant.