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WordPlay Enrollment Form
Use this form to register your student for a Wordplay class or workshop! Please complete this form for each workshop that you are registering your student for.
Email Amy Tuttle,
amy@wordplaycincy.org
, with any questions about our offerings.
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* Indicates required question
Email
*
Your email
Name of Parent/Guardian:
*
Your answer
Phone Number:
*
Your answer
Which Wordplay program would you like to register for?
*
Open Mic Night
The Story of Me
Wheel Crew
Poetry & Healing
Other:
Student's Name and Age
*
Your answer
What school does your student attend?
*
Your answer
Zip Code
*
Your answer
Gender Identity or Preference
She/her/hers
He/His
They/Theirs
Clear selection
Parent/Guardian: Please type your name below as a form of electronic signature if you agree to our use of images and video clips from our virtual classes used for Teaching Artist training, program storytelling, and marketing/outreach materials.
*
Your answer
Would you like to be included in our newsletter to receive information about special programs, events, and WordPlay news?
*
Yes
No
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