Blue Pearl Theatrics

Blue Pearl Theatrics

Summer Performing Arts Program Registration Form
Student's Name

First NameLast Name
Age
School Grade
Parent Email Address:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent Name

First NameLast Name
Parent Phone Number

Area CodePhone Number
Parent Name

First NameLast Name
Parent Phone Number

Area CodePhone Number
Person to be contacted in case of emergency (other than parent)
Contact Name
Contact Phone Number

Area CodePhone Number
Contact Name
Contact Phone Number

Area CodePhone Number
If no contact is made, I give permission for my child to be transported to the nearest medical facility
Signature (Type name as signature)
Does your child have any medical conditions, past injuries, or allergies that we should be aware of?
If yes, please explain
Siblings who will also be attending Blue Pearl Theatrics Summer Performing Arts Program:
Name of person/s who can pick up your child:
How did you hear about Blue Pearl Theatrics Children's Theater Program?
Please describe your child's acting/dancing/performance experience:
PAYMENT METHOD:

(Check, money order, or C.C. must be in U.S. funds made payable to Blue Pearl Theatrics.)

Please check appropriate option below:
Enclosed is my payment:
Payment Information

Summer Performing Arts Program - 8 weeks$225.00

July 11 - August 29, 2026 - Ages 7-14 - Saturdays July 12 - August 30, 2026 - Ages 15-17 - Sundays

Summer Performing Arts Program - Payment Plan Deposit$115.00

Payment Plan - 2 installments of 115

Total $0.00