Theater Plus! Fall 2017 Program Enrollment
You may use this form to enroll in one of our Fall 2017 programs.

You also have the option of paying online through Square Up -- https://mkt.com/theaterplus

If you have any questions, please contact the Program Director, Stacey Shanahan at stacey@theaterplus.org or 781-308-7916.

Participant's First Name
Your answer
Participant's Last Name
Your answer
Current Grade in School
Name of School
Your answer
Mailing (Street) Address
Your answer
Town
Your answer
State
Your answer
Zip Code
Your answer
Email Address
Your answer
Parent/Guardian #1 Name
Your answer
Parent/Guardian #1 Contact Phone Number
Your answer
Parent/Guardian #1 2nd Phone Number
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Phone Number
Your answer
Emergency Contact Name
This person will only be contacted in an emergency, if Parent/Guardian #1 and #2 cannot be reached.
Your answer
Relationship to the student
Please let us know how the emergency contact is related to the student.
Your answer
Emergency Contact Phone Number
Your answer
Is the participant allergic to anything?
Required
If yes, please list allergies:
Your answer
Does the participant have any physical limitations?
Required
If yes, please list physical limitations:
Your answer
Is there anything about your child that you would like us to be aware of?
Your answer
During the course of the session, we may take photographs and videos of our actors and techies working on our shows. Do we have your permission to use these photographs/videos in our publicity?
Required
Which program are you registering for?
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