Child Name *

Parent Name *

Email *

Phone number *

Ok to text? *

Child Age and Grade *

Which program are you registering for? *

Payment Options $169.00 *

Emergency contacts with phone number (in case parent not available.) *

Who may pick up your child? *

What experience has your child had onstage?

Any information that we should know about your child? (Medical concerns, allergies, accommodations needed etc.)

T-Shirt Size (please note adult or child size)

Please know that during our program participants will be expected to provide and wear their own masks at all times until further notice. We will encourage kids to wash hands often and avoid unnecessary physical contact with others; however, it should be know that we will not be responsible for maintaining a 6' social distance between performers. During the performance performers will be provided a clear plastic face guard to use during the show or they may choose to wear their own solid color mask. With times as they are, please also note that in the unexpected event of any COVID related scares within the club (potential exposure, positive tests etc.) that causes the program to be fully cancelled, we will offer tuition credit towards a future program in lieu of refunds. Checking the box below is representative of my signature and understanding of the above information. Additionally I acknowledge that I understand the potential risk of exposure to COVID-19 by my child participating in group activities even with the safety measures listed. *