Willy Wonka Jr. Registration
***NEW START DATE***
 Cast A: Tuesday Jan. 14th 4:30pm-5:55pm
Cast B: Tuesday Jan. 14th 6:05pm-7:30pm
Cast C: Monday Jan. 13th 6:05pm-7:30pm

Please fill out the form below. Within one week, you will receive an invoice including $15 registration fee per student and January tuition via QuickBooks secure pay portal. Register BEFORE Christmas and pay no registration fee! If you have any questions, please call Elizabeth Clevenger at 256-468-3093.
***CAST C IS WAITLIST ONLY***
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Choose your desired cast *
Student Name(s) *
Student Age(s) *
Parent Name *
Billing Address *
Billing Email Address: This email will receive all online invoices and production information. *
Additional Email Addresses: List any email addresses that should also receive production information. Example another parent, grandparent, babysitter etc.
Phone *
List 2 emergency contacts with phone numbers, other than yourself *
List any allergies or other special needs of the student(s) *
List all persons allowed to pick up the student(s): If their name is not on the list, they may not pick up the student unless a written note, text, or e-mail is given. *
I give permission to ClevengerCreations to use the student's image for marketing and or archival purposes. Photos/Videos may be shared on Facebook, Instagram, and all media outlets. *
I will not hold ClevengerCreations, Devin, or Elizabeth Clevenger responsible for any injury that may occur while at ClevengerCreations 96537 Parliament Dr. Fernandina Beach, FL 32034. *
I have read and agree with the 'Parent Packet' *
If new, who referred you to ClevengerCreations?
Would you like to order your child(ren) a non-mandatory show t-shirt? This shirt will be used for potential non-mandatory community performances. Cost $20 to be included in initial invoice.
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