First Stage in the Northend Registration Form
Mosaic Youth Theatre of Detroit's mission is to  empower young people to maximize their potential through professional performing arts training and creation of theatrical and musical art that engages, transforms and inspires.

Mosaic's First Stage Programs introduce Young Artists, Grades 5th-10th, to Mosaic's brand of high-energy, empowering and inspiring performing arts training.  Cast members of Mosaic First Stage learn the basics of performance: articulation, projection, movement through high energy games, scenes and monologues.  The Program culminates with a showcase for family and friends on the big stage!

 No experience necessary to participate. There is no fee to participate in this program.


Winter Session:
January 26th - April 4th, 2016
Tuesdays & Thursdays
4:30-6:30 PM

Showcase: Friday, April 4th ; 6:00 PM

Mosaic First Stage Program in the Northend takes place at
Don Bosco YouthVille Detroit
7375 Woodward
Detroit, MI 48202

Sign in to Google to save your progress. Learn more
Young artist's (Student) last name *
Young artist's first name *
Young artist's street address *
Young artist's city of residence *
Young artist's state of residence *
Zip Code *
Young artist's home phone number *
Young artist's email address *
Young artist's date of birth  (MM/DD/YYYY) *
Young artist's school *
What grade will the young artist enter in the Fall? *
Gender *
Young Artist Age *
Disability *
How did you hear about Mosaic? *
Race (Please select all that apply) *
Required
Major Cross streets *
Side of town *
Parent/ Guardian name (Last, First) *
Parent / Guardian street address *
Parent / Guardian City *
Parent / Guardian State *
Parent / Guardian Zip Code *
Home Phone *
Cell phone *
Work Phone
Parent / Guardian email address *
Employer *
Primary Lauguage *
Relationship to young artist *
Parent / Guardian 2 Name (Last, First)
Parent / Guardian 2 street  address
Parent / Guardian 2 state
Parent / Guardian 2 Zip code
Parent / Guardian 2 Home Phone
Parent / Guardian 2 Cell Phone
Parent / Guardian 2 Work Phone
Parent / Guardian 2 Email Address
Parent / Guardian 2 Employer
Parent / Guardian 2 Primary Language
Clear selection
Relationship to young artist
Clear selection
Emergency Contact Person 1 Name (Last.. First) *
Emergency Contact Person 1 Telephone Number *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mosaic Youth Theatre of Detroit.

Does this form look suspicious? Report