Greetings and Welcome to Shake The Stage!

The African-American Shakespeare Company’s Shake the Stage Enrollment Program is back this Fall at our Creative Space located at 460 Gough.

Program Details:

ACTING w/ Mr. James, Wednesday's 4:30pm-6pm @ 460 Gough 

• Students will Develop stage presence, character work, and storytelling skills. Grades 6-8 only, 5th graders will be considered if they have been apart of STS Summer Productions: The Wiz Jr. OR Schoolhouse Rock Jr. 

Shake the Stage Tuition (September 16th–December 16th)
This is a year-long program running from September through May.

• 1 Class: $60 per month

Billing: Families will not receive their first Shake the Stage tuition invoice until the first week of October. and payments will be due the first week of the month there after. 

Additional Performances:

Performance Opportunities
Our Shake the Stage performers will shine on stage throughout the year with multiple performance opportunities. This winter, students will have the chance to:

• Audition for AASC’s Annual Production of Cinderella – our landmark holiday production at the Herbst Theatre.
• Participate in Community Performances – showcasing their talent at local events and celebrations.

These performance experiences give students the opportunity to put their training into practice, build confidence, and share their artistry with the community.

Parent/Guardian Information

Emergency Information

DCYF Informed Consent & Acknowledgement 

The San Francisco Department of Children, Youth, and Their Families (DCYF) funds our agency and the services we provide. To fulfill the requirements of this funding, we share information about the participants in our services with DCYF. DCYF and the San Francisco Unified School District (SFUSD) maintain a shared, secure database to record information about services provided to San Francisco youth by DCYF’s grantees in order to facilitate outreach and enrollment and track program use and impact. As a DCYF grantee, our agency has access to the shared database to both see and report data about the youth we serve. The data that we report to DCYF is also shared with SFUSD.

By signing this form, you authorize
1. Our agency to share information about your child’s participation in our program (or your participation, if you are 18 years of age or older) with authorized staff at DCYF and SFUSD for the purposes described above.

The information that our agency reports to DCYF includes:
• Person information, such as name, date of birth, and address:
• Demographic information, such as race/ethnicity and gender identity;
• Education information, such as school name and grade level;
• Participation in activities and services, such as dates of attendance dates and hours attended; and
• Anonymous and voluntary youth experience surveys.

2. SFUSD to share certain information about your child (or you, if you are 18 years of age or older) with authorized staff from our program as a DCYF grantee. The information that SFUSD reports to DCYF includes:
• Personal information, such as name, date of birth, and address;
• Education information, such as school name and grade level; and
• Dates of attendance in SFUSD or an SFUSD school.

DCYF, SFUSD, or our agency will not publicly report any information that we provide in a way that may be used to identify your child (or you, if you are 18 years of age or older).

Restrictions: All information that we provide or access that is related to an SFUSD student is protected by federal and state laws that govern the use, disclosure and re-disclosure of student education records. Parties other than DCYF, SFUSD and our agency will not have access to any personally identifiable information that is reported into the database, except to the extent that the parties have obtained prior written authorization from you or have followed SFUSD policies and procedures to obtain access to such information.

Expiration: This authorization expires on June 30, 2029.
Your Rights: You may refuse to sign this form. You may cancel it at any time by information our agency in writing. If you cancel your permission allowing us to release information to DCYF and SFUSD, and SFUSD to our agency, it will go into effect immediately, unless the information has already been released. You have a right to receive a copy of this form.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by African-American Shakespeare during the selected program. In exchange for the acceptance of said child’s candidacy by  African-American Shakespeare, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless African-American Shakespeare and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against  African-American Shakespeare Company, including all employees, trustees, and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities which may include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Release and Authorization

As Parent and/or Guardian of the named youth participant, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical treatment for the named participant. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the  African-American Shakespeare Company and its affiliates including Directors, Instructors, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.