Acting Out New York Registration Form
Please fill out the information below to complete your student registration. At this time, this form isn't supported by mobile devices, so please fill it out from a laptop or desktop computer.

Within 24 hours of registration, you will receive a PayPal invoice for the tuition at the email you provided. This confirms your registration. If you have any questions please email or call. (actingoutnewyork@gmail.com or 310-717-5405)

Your Name and Relationship to Student *
Your answer
Name of Student *
Your answer
Gender your child identifies with *
Please list all adults who have permission to pick your child up. *
Parents, grandparents, step parents, nannies, etc.
Your answer
Does your child have any medical concerns? *
The honest answering of this question will in no way inhibit your child's enrollment. It is just so we can adjust the curriculum to ensure all the children involved maximize their potential!
Your answer
Does your child have behavioral or emotional concerns? *
Answering this question honestly will in no way inhibit your child's enrollment. It is just so we can adjust the curriculum to ensure all the children involved maximize their potential!
Your answer
Is your child up to date on their vaccinations? *
My husband is immunocompromised right now due to chemotherapy treatments, so unfortunately, we need up to date vaccine records for all AONY participants. If this excludes you, please do check back for our spring programming, as we'll be out of the woods with cancer treatments and able to include non-vaccinated children back at AONY!
Does your child have any allergies? *
Your answer
Child's Age *
Your answer
Parent's Email *
Your answer
Parent's Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Are you signing up with a friend? What is their name?
Your answer
Which program are you signing up for? *
Would you like to include a headshot session with your camp registration? *
ATTN: Movie Campers- If you would like your child to receive a head shot session with Julia DeFrank of Fayerbanke Foto, please click "yes" below. A $25 fee will be added to your camp invoice, and that will cover your camper's head shot session with Julia plus one edited high res jpeg (an awesome deal)!
Would you like to make a small donation to the scholarship program at Acting Out NY?
Suggested donation is $25, but any amount will help! The donation will be added to your PayPal invoice.
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