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Showstoppers 2023 SPRING
Registration
Ages 6 to 14 Dates January 17 to March 18, 2023
AFTER SCHOOL
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* Indicates required question
Email
*
Your email
First Name of Actor
*
Your answer
Last Name of Actor
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
School Actor Attends
*
Your answer
Gender
*
Male
Female
Age when session starts
*
Your answer
Actor's Home Address
*
Your answer
Zip Code
*
Your answer
Who does actor live with?
*
Both Parents
One Parent
Guardian(s)
Other:
Name of parent or guardian registering Actor
*
Your answer
email address of parent or guardian
*
Your answer
cell phone number of parent or guardian
*
Your answer
Second Parent or Guardian
*
Your answer
Best phone number for this parent
*
Your answer
Second parent Email address (if different from yours)
*
Your answer
Please list an emergency contact, in case parents and/or guardians cannot be reached. Parents are always contacted first.
*
Your answer
Emergency contact's relationship to your child.
*
Your answer
Emergency contact's best phone number.
*
Your answer
Health Insurance carrier
*
Your answer
Policy #
*
Your answer
Doctor and Medical Group
*
Your answer
Doctor or Medical Group's phone number
*
Your answer
Does your child have any medical conditions, allergies, or special needs that the directors should to be aware of?
*
Your answer
If so, please list
Your answer
What information or special equipment do we need while your child is in our care?
*
Your answer
What is your name?
*
Your answer
I understand that payment for the tuition must be made before enrollment is complete.
*
yes
No, I will call or email you for more details
I am enrolling my child for 2023 Spring After School. Show dates are March 17 & 18, 2023
sbshowstoppers@gmail.com
or call (805) 699-6077 for payment information.
*
yes
No, I will call or email you for more details
Tuition is $525, How will tuition be paid?
*
I will pay $525 Online at Square
I will pay $525 by check Showstoppers 3579 Modoc Road Santa Barbara CA
I confirm that all information I have entered is correct and complete.
*
Yes
Option 2
Required
Electronic Signature By checking "I agree" I affirm consent, and agree that: My electronic signature on this form above the same effect as if I signed this form in ink.
*
I agree
Required
Your legal name
*
Your answer
Send me a copy of my responses.
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