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APPLICATION FORM
Please check the class information, complete all required fields and submit.
Name of Class: 
MASTER CLASS
Instructor: 
Mr. David Rotenberg (davidcrotenberg@gmail.com)
Location of Studio: 
Connect Studio, 210 N Pass Ave, Suite 206, Burbank
Dates and Times: 
Saturdays at 6pm, Jan 26, Feb 2, 9, 16, 23
Price: 
$500.00 USD
      Are you 18 years of age or older?   (parental consent is required if under 18)
Your Full Name:
Your Email:
Verify Email:
Phone:
  Alt Phone:
Payment Method:
Cheque | Money Order | Bank Draft PayPal or Credit Card

NOTE: If paying by cheque or money order, please make session fee payable to: "David Rotenberg."

If you chose PayPal, you will be asked to send USD payment to davidcrotenberg@gmail.com. Be sure to record any transaction ID numbers and save any confirmation emails sent to you.

Please read: In consideration of being permitted to participate in any way in the training and other activities of David Rotenberg or The Professional Actors Lab, I agree to pay all fees and charges, and I acknowledge that David Rotenberg or The Professional Actors Lab reserve the right to determine my continued participation in such training and activities. Should discontinuation of participation be required, refund if allowed will be pro-rated accordingly by David Rotenberg.
    On behalf of myself, my heirs, executors, successors, administrators, assigns and whomever else may have an interest either at common law or by operation of statute, I hereby waive any and all claims I or such parties may have now and in the future, and release from all liability and agree not to sue David Rotenberg, Joe and Beth and She and Me Productions Ltd., or The Professional Actors Lab, their officers, directors, employees, contractors and agents (the "Releasees"), for any and all personal injury, property damage or loss sustained by me as a result of my participation in classes or other activities held at the Pro Actors Lab studios due to any cause whatsoever, including, without limitation, negligence on the part of the Releasees.
      I confirm that I have read and understand this agreement and am aware that in signing I am waiving certain legal rights and enter into this agreement of my own free will and volition.

  I understand and agree to the above waiver.


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application deadlines, classes or workshops?*

A confirmation email will be sent automatically upon successful submission.
Your instructor will notify you, if or when you are accepted into class.

*Professional Actors Lab and it's affiliates comply with The CRTC's anti-spam legislation. If at any time in the future you
wish to UNSUBSCRIBE from our eNotifications, please do so here or email your instructor.