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! Thank you!

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 at any time. (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
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
Registration for Summer Programming is now closed.
Your answer
How did you hear about Acting Out! New York?
If you answered "other" above, please tell us how you heard about Acting Out NY.
If you were recommended by a friend, please give us their name so we can thank them!
Your answer
Are you signing up with a friend? What is their name?
Your answer
Would you like to make a small donation to help create a 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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