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Personal Information

Full name
Age
Parent(s) or Guardian(s) name(s)
Home address
Home phone
Mobile or cellular phone
Home e-mail address
Birthday (MM/DD/YYYY)
Additional Comments

Program Information

Please check each program you wish your child to attend.

Early Stages
Jr. Music Theatre
Sr. Music Theatre
Jr. Film and T.V.
Sr. Film and T.V.
Drama
Triple Threat Camp

Emergency and Medical Information

In case of emergency, contact
Emergency contact's address
Emergency contact's phone
Known medical conditions
Allergies
Relevant Medications
Reason(s) why your child may not be able to participate in any aspects of the program(s)