Bard for Life Participant Form

Fall Session 2018

Please fill out this form as clearly as possible, with one form for each participant.

The workshops will run Wednesday evenings starting September 5 until October 24, from 6:30pm to 9pm. All workshops will be held at the BMO Theatre Centre (162 West 1st Ave, Vancouver, BC)

Bard for Life Participant Form: Winter Session 2019

If you are human, leave this field blank.

Participant Information

First name *

Last name *

Emergency contact name *

Relationship to participant *

Cell phone *

Participant Health & Safety

Health information is confidential and available only to relevant staff and Teaching Artists at Bard on the Beach. This information assists us in providing an informed response in the case of an emergency situation for the program participants. There is additional space provided for notes at the end of this form, so please provide us with as much detail as possible.

Do you have any health concerns that you wish us to know about?

Do you carry an epi-pen? *

Yes

If yes, do you know how to administer it?

Yes

Is there anything else you would like us to know that would help us better support you?

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Bard for Life Participant Form

Fall Session 2018

Participant Information

Participant Health & Safety