Act Up Arts Pre-Registration Form
What program are you interested in enrolling with?
Act A Part - Acting (ages 12-17)
Music & Movement (Get that energy out!) ages 3-11)
Stage Fright To Spotlight - Confidence Boosting (4-11)
Act Up Audition Prep (all ages) - Private lesson
Voice - Private lesson
Student Information
Student Name
First Name
Last Name
Age
Date of Birth
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
-
Area Code
Phone Number
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you prefer in person, virtual, or hybrid classes? (Location TBD!)
Skills, Talents, and Hobbies. What are your child’s favorite things to do?
Parent/Guardian Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Relationship
There will be a $30 registration fee to save your child’s slot. Do you agree?
Any additional comments or information you would like to share?
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