Performing Arts Signup Form

Registration

Fill out the form carefully for registration
Future Student’s Name*

First NameMiddle NameLast Name
Future Student’s Name #2

First NameLast Name
Future Student’s Name #3

First NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact E-mail*
example@example.com
Mobile Number*

Area CodePhone Number
Enroll In Classes*
Emergency Contact #1

First NameLast Name
Phone Number*

Area CodePhone Number
Emergency Contact #2

First NameLast Name
Phone Number*

Area CodePhone Number
Questions or Comments
Choose Class Start Date
My Products
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Performing Arts$175.00
Monthly Payment

Quantity

Performing Arts$50.00
Weekly Payment

Quantity

Adult Acting Classes$175.00

Quantity

Total $0.00
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