House Theatre Registration

Dance House

Complete the form below to register for House Theatre participation.
Please verify the program and grade level you are registering for.
Junior Grade 6-8*

Verify that student is age 11 by September 1, 2024.Verify that student is in grade 6, 7, or 8.
Name Student*

First NameLast Name
Name Parent 1*

First NameLast Name
Name Parent 2

First NameLast Name
Name Primary Caregiver if Applicable

First NameLast Name
Date of Birth*

MonthDayYear
Date
Grade Level*
T-Shirt Size
If ordering additional Dance House T-Shirt(s), please indicate adult or child size(s) and number of shirts.
E-mail*
example@example.com
Phone Number:*

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Rules
Membership is available to homeschoolers in grades 1st through 12th who have read, understood, and agree to demonstrate respect towards House Theatre's Code of Conduct and Statement of Faith.
Please Check The Following

I have read, understood, and agree to demonstrate respect towards House Theatre's Code of Conduct and Statement of Faith.
Medical Waiver

Applicants must complete a medical waiver to participate in Dance House.
Emergency Contact Name 1*

First NameLast Name
Relation to Participant*
Phone Number*

Area CodePhone Number
Emergency Contact Name 2*

First NameLast Name
Relation to Participant*
Phone Number*

Area CodePhone Number
Insurance Card Information
Indicate medical history deemed necessary by the parent. The attached waiver is provided for transparency and clarification.
Are there any allergies we should be made aware of?
Date of Form Completion

MonthDayYear
Date
Once you submit your application, we will contact you shortly to complete your membership application. Thank you!
My Products*
prevnext( X )
Dance Junior Materials Non-Refundable$25.00
Includes one Dance House T-Shirt for Dance Showcase.

Quantity
Item subtotal:$0.00

Additional Dance T-Shirt Non-Refundable$20.00
Additional T-Shirt(s) (20.00 each) may be ordered for any family member or as an extra shirt for student's Dance Showcase wardrobe.

Total $0.00

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Dance House

Membership Rules

Medical Waiver