Register for Musical Theatre Classes

Please complete this form and we will contact you to finalise the details.
* Required fields

Student Information

First Name:*

Last Name:*

Age:*

Birth Date:*
Day: Month: Year:

School:

Parent/Guardian:

Medical Information
Do you take Medication?* Yes \| No (if yes please give details in the box below)
Do you have Allergies?* Yes \| No (if yes please give details in the box below)
Do you have a Learning Disability?* Yes \| No (if yes please give details in the box below)

Contact Information

Phone & Email
Home: *	(Phone Number)
Work:	(Phone Number)
Cell:	(Phone Number)
Email: *	(E-mail)
How would you like us to contact you?* Home Phone \| Work Phone \| Cell \| Email

Class Information

Class Day and Number of Weeks:*

Classes will be limited to 12 students. First come, first served.
.

Cost per Term:

Holidays will be as follows:

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