Jungle Book Kids

Jungle Book Kids 5-6th Grade Student Registration Form

Once you complete this form, you will be redirected to PayPal to make payment to complete registration. Fill out the form carefully for registration
Student Name*

First NameMiddle NameLast Name
Gender
Age
Please tell us what school you currently attend.
Parent Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent Phone Number*

Area CodePhone Number
Parent Phone Type*
Parent E-mail*
Photo Release Form for Minors (if under 18): Rooted Tree Productions, Inc. has my permission to use my or my child’s photograph for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet (including Facebook, Instagram, etc. or other media sources). I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.*
Additional Comments
Should be Empty:

Jungle Book Kids 5-6th Grade Student Registration Form