EDUCATION PROGRAMS 2010-2011 REGISTRATION FORM

To register online, complete the form below. After submitting this form you will be directed to
PayPal where you can make payment with your credit card or PayPal account.
(A PayPal account is not required to pay with a credit card via PayPal)
PayPal

Note: One registration for per student. Payment must be made at time of submitting this registration form.

 STEP 1: Please complete the requested information. Parents of students 17 and under should complete section 1A. Students 18 and over should complete section 1B.

SECTION 1A
Address and contact information for STUDENTS 17 AND UNDER (students 18 and over should skip to section 1B)
Student Name:
Street Address:
City/State/Zip:
Birthdate (mm/dd/yy):
Age:
Parent/Guardian Name:
Parent/Guardian Address:
City/State/Zip
Parent/Guardian Daytime Phone:
Parent/Guardian Cell Phone:
Parent/Guardian E-mail:
   

SECTION 1B
Address and contact information for ADULT STUDENTS (18+):
Student Name:
Street Address:
City/State/Zip:
Daytime Phone:
Cell Phone:
E-mail address:

 STEP 2: Please review the list of classes below and check the box(es) next to the desired class(es) and enter the fee in the column on the right.

CLASSES FEE
ADVENTURES IN THEATRE  
Animals in Action! ages 6-8, Saturdays. Oct. 29-Dec. 10, 9:30-10:30    $75
Building a Character ages 9-13, Saturdays. Oct. 29-Dec. 10, 10:45-Noon    $90
ADULT CLASSES  
Adult Acting Class ages 16 and up, Mondays, Sept. 12-Oct. 17, 5:00-7:00   $150
 
TOTAL DUE: