Orchesis Children's Workshop Registration 12/2/2017
Email address *
Child's Last Name *
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Child's First Name *
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Parent/Guardian Name *
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Street Address *
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City, State *
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Zip Code *
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Day/Evening Phone Number *
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Emergency Phone Number on 12/2 *
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Extra Ticket ( s ) $5 Each
Grade in School *
Pizza Party 6:15-7:00 (optional $5) If you are not choosing this option, you must pick your child up to eat and return them to the theatre by 7:00. *
T-shirt Size (sized only guaranteed for registration received by November 20th) *
Did you attend last year ? *
Workshop Choice #1 *
Workshop Choice #2 *
Please list any health concerns *
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Additional Donation to Wheeling HS Orchesis to help underwrite our guest artist programs
Total Amount Due ($30 workshop, tickets, pizza, any donation) *
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Check # and date mailed. Checks must be received by November 27th. After that time please register at 3:30 on Saturday 12/2 for available workshops.
Mail to Wheeling HS 900 S. Elmhurst Rd, Wheeling, IL 60090 attn Diane Rawlinson.
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How did you find out about this workshop? If an Orchesis member recruited you...please list their name
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