YPAC808 - “Godspell" Jr.
REGISTRATION
First Name *
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Last Name *
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Gender *
Age & Birthday *
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Grade Level and School Name *
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Student Email Address (if no email address, write NONE)
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Student Mobile Phone Number (if no personal phone, write NONE)
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Parent/Guardian First Name *
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Parent/Guardian Last Name *
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Parent/Guardian Email Address *
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Parent Guardian Mobile Phone *
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Home Address *
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Home Phone (if applicable)
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Emergency Contact Info. - Name, Relationship, Phone no. *
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*Waiver Form (see below): choose one as your signature *
Waiver Form
Medicine or Food Allergies? (please list)
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T-shirt Size (Please specify Child or Adult Size) *
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List Singing/Acting/Dancing Experience
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Additional Comments
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*Registration questions or problems? Please contact Dane Ison (Director) at ypac808@gmail.com
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