Academy of Theatre Arts                    2019/2020 Season Registration Form
*Please make sure email address is up to date and checked frequently. We use a completely electronic system.
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Email *
Student Last Name *
Student First Name *
Age & Birth Date *
Address *
Mother's Name *
Father's Name *
Email Address *
Phone Number *
Emergency Contact *
Class Selection (Please check which classes you would like to participate in for the 2019/2020 Season) *
Required
PARENTAL CONSENT:I agree by checking to follow all policies and procedures set forth by Academy of Theatre Arts.  I accept the responsibility of reading and following all information communicated by the Academy.  I further accept all responsibility of any potential risk associated with participating in a theatre class, and affirm that I have and will provide proper health insurance for my child’s protection.  I give permission for  emergency  medical treatment of  my child if a parent cannot be contacted.  I hereby grant  permission for my child to be photographed by Academy of Theatre Arts for publicity and/or production purposes.
$55.00 Non-Refundable Registration Fee Received ($75 per family): *
Required
If paying by Credit Card (Call in card or leave information below)
Credit Card Number
Expiration Date
CVC
I would like my card to be on file for monthly billing:
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