Register

JP Creatives

Registration

Please complete and submit one registration form per child then click on Buy Now to submit separate payment for each child. Thank You.

Release

By clicking the "Submit" or "Buy Now" buttons below, I give permission for my child to participate in JP Creatives' Digital Storytelling Class. I do hereby consent to the reproduction, use and distribution of my child’s name, likeness or identifiable voice, in whole, or in part, in original or modified, form alone or in conjunction with broadcast, electronic media, art work, other sketches, and text material throughout the universe for use in media for JP Creatives. I assign the rights of copyrights to such material to for JP Creatives and release it and its nominees, clients and successors from any liability arising out of such use of my child’s name, likeness, or identifiable voice in any and/or all media.

Acknowledgment of Release:	I AGREE

School: *
Date: *
Title: *
Parents/Guardian First Name: *
Parents/Guardian Last Name: *
Email Address: *
Address Lines: *
City: *
State: *
ZIP: *
Home Phone: *
Work Phone:
Cell Phone: *
Child's Name: *
Age/Grade: *
Number of Children You Will Enroll: *

All Payments include a $4.00 service charge. Please complete one registration/payment per child.