Kúkátónón Troupe Member Registration 2018/2019 Performance Season Open Enrollment
Thank you for filling out this Troupe member registration form, and be sure to fill out one per child. This form is mandatory for children to participate in Kúkátónón.

PLEASE HAVE THIS FORM COMPLETED BY SUNDAY, OCTOBER 30th, 2018 OR SOONER and your $50 registration fee paid by Thursday, November 1, 2018. Although you can fill out this registration form online, registration fees must be delivered in person to our Business Operations Manager, Danielle Ali-Cassim. If you would like to request a registration fee waiver, contact us for more information.

We accept cash or checks for registration fees (please make checks payable to: Kúkátónón). If you have questions, please contact Ms. Curtrina at busops@kukatonon.org or (503) 756-5312. Thank you!

Email address *
TROUPE MEMBER INFORMATION
Please answer the following questions with information about your child. A section for parent/guardian information will follow.
Member First Name *
Your answer
Member Last Name *
Your answer
Member Phone Number (if different from parent) *
Example: 503-123-4567
Your answer
Member Date of Birth *
MM
/
DD
/
YYYY
Member Age *
Your answer
What School does Member attend? *
Your answer
Member's Grade at School *
Your answer
Member Gender *
Your answer
Medical Information
Please check all that apply and provide a description below.
Please indicate your child's race and ethnicity (used for grant reporting purposes) *
If you answered "Two or more ethnicities" above, please let us know with which ethnicities you identify
Your answer
Is your child eligible for Free or Reduced price lunch at school? *
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