SGT Program Registration Form
Please complete this registration form if you would like to participate in one of our programs.

If you are a new student please click here for more information.
If you are a new peer mentor/buddy, please click here for more information.
Once you complete the online registration form, someone will be in contact with you regarding the next steps. 

**All students/peer mentors/buddies…If you have already registered for the upcoming season, please be sure to complete the Comprehensive Registration Profile Google form that was sent to you in a separate email.  If you have any questions about this process, students can contact Janet @ jczarnecki@specialgiftstheatre.org and peer mentors can contact Dawn @ dgoerger@specialgiftstheatre.org.     

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Email *
Choose a registration type from below: *
Please select the program(s) you are registering for below: *
Required
Full Name (include first & last names) *
Name of school & grade in school (if participant is not in school, please answer N/A): *
Age: *
Date of birth (EX: 01/01/2023): *
Gender: *
Do you have preferred pronouns? (optional)
Parent(s)/Guardian(s) Name(s): *
Full address (please include street number/street name, city, state & zip code): *
Parent/Guardian phone number: *
Parent/Guardian email address: *
How did you hear about our programs?
Chid's diagnosis (answer for students only - optional):
Is there any additional information, comments, or questions you would like to share with us? (optional)
If you have any questions, please send an email to info@specialgiftstheatre.org, 
or call 847-564-7704.  

Thank you for registering!  We will be contacting you soon!
A copy of your responses will be emailed to the address you provided.
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