Child's Name *

Child's Birthday *

Please advise us of any medical conditions or allergies you would like us to be aware of: *

Contact Parent's Name *

Phone Number *

Email Address *

Postal Address *

Class Selection: *

Fee Payment Preference *

Does your child have a sibling enrolling or currently training with us? (5% Family Discount applies) *

Sibling's Full Name *

Photographs and videos of students may be used in a variety of media to celebrate a student’s success and may also be used in promotional mediums such as Instagram, Facebook, websites as well as other print media. Students will also be filmed as part of regular showcase performances. I give permission for my child's image to be used and am aware that this may be accompanied by my child’s first name. (Please type your full name to sign) *

I acknowledge I have read and agree to the Policies and Procedures available at: https://www.theatreblacks.com/junior-academy *