Registration Form for Theatre Classes
Print this page and mail it with payment to the address given below. You may also register by telephone (425/881-6777).
Please have all of the following information ready.
Contact Information
Student's
Name: _________________________________________________________________
Grade:
______________ Age: ____________ Birth date: ______________________________
Parent/Guardian's
Name(s): ________________________________________________________
Address:
_______________________________ City: ___________________ Zip: _________
Day
phone: _____________________________ Evening phone: __________________________
Email
Address:
(print clearly)
Class Desired
Class Name(s):____________________________________________________________________
Payment
Payment Method:
Please apply to:
Payment:
___________________
Donation:
_________________
Total
Amount: _____________
SecondStory Repertory
is a not-for-profit theatre arts and education program. Because
of this we are constantly looking for volunteers and donors to keep
our programs open. If you are interested in volunteering, please
call us. If you cannot give of your time, please consider a tax-deductible
financial contribution.
Card
Number: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Exp.
Date: __ __ / __ __
Signature:
__________________________________________________________________
All
registrations must be accompanied by a $50 deposit per student per class.
Remainder is due one week before the start of class. Mail this form to:
SecondStory
Repertory, 16587 NE 74 Street, Redmond WA 98052
