ACT 3 ACTING STUDIO Class and Camp Registration
act3actingstudio@gmail.com
KJ Rugerio, Artistic Director
Email address *
Student Name *
Your answer
Student Birthday *
Your answer
Student's Age *
Your answer
Parent (s) Name (s) *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone number *
Your answer
Authorized pickup adults *
Your answer
All pictures taken during camp are property of ACT III and may be used for promotion and publicity of ACT III events and activities. *
Required
Medical concerns *
Your answer
Insurance Company/Policy *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Phone Number: *
Your answer
Camp selection (s) *
T shirt size *
Hit SUBMIT, Complete your payment by Double CLICKING on the return/back button. You will be able to select the appropriate BUY NOW button(s) and fill in credit card info.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms