Summer Youth Theatre Experience at Syracuse Stage 2020
Registration form for the Summer Youth Theatre Experience. Payment can be processed through this link (https://sforce.co/2R13qDn) or by sending a check made out to Syracuse Stage, Attn: Kate Laissle, Syracuse Stage, 820 E Genesee St, Syracuse, NY 13210. Your spot will not be saved until we receive your $50.00 non refundable deposit.
Email address *
Which weeks are you registering for? (Select all that apply.) *
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Participant first and last name *
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Gender Identify *
Date of Birth *
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School in Fall 2020 *
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Select Grade in Fall 2020 *
Home Address *
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City *
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Zip Code *
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Parent/Legal Guardian Name(s) *
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Parent/Legal Guardian Email *
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Parent/Legal Guardian Phone Number(s) *
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Persons Authorized to Pick Up Participant *
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Other Dismissal Arrangements *
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Emergency Contact Name, Relationship, Phone Number *
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Specify any health problems or allergies *
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Is the participant on any medications? *
If so, please specify:
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Doctor & Phone Number *
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Insurance Carrier & Policy Number *
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