Student's Name *
Student's Name
Parent 1 Name *
Parent 1 Name
Parent 1 Phone# *
Parent 1 Phone#
May we text you on this line? *
Student's Address *
Student's Address
Parent 2 Name
Parent 2 Name
Parent 2 Phone#
Parent 2 Phone#
May we text you on this line?
Emergency Contact Name (different from parent 1 or 2) *
Emergency Contact Name (different from parent 1 or 2)
Emergency Contact Number (different from parent 1 or 2) *
Emergency Contact Number (different from parent 1 or 2)
Please list anyone (including yourself, another parent, and the emergency contact) who may pick up your child after class.
Enrolling in (check all that apply): *
How did you hear about our theatre classes? (please select all that apply) *