Light UP FREE TRIAL Registration
Welcome to Light UP Drama classes! Please fill in all the details requested so we can get you set up with the right class for your child. If you are bringing more than one child, a registration form must be submitted for each of them.
Email address *
First Name of Student *
Your answer
Surname of Student
Your answer
Male or Female *
Participant's Date of Birth *
MM
/
DD
/
YYYY
Primary Phone Number *
Your answer
Does the participant have any medical issues or dietary restrictions that we should be aware of? *
Your answer
Emergency Contact Number *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Surname *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Light UP. Report Abuse