Rising Stars: Hip Hop & Musical Theatre (2nd-4th grade) Registration Form
Questions?  E-mail Mrs. T. at hiphoptelestai@gmail.com 
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Student's Name: *
Grade Level *
Required
Adult 1 Name *
Adult 1 E-mail *
Adult 1 Phone *
Adult 2 Name
Adult 2 E-mail
Adult 2 Phone
Any health or learning notes for Mrs. T.? (asthma, diabetes, allergies, ADHD, autism spectrum, etc.)
I acknowledge that this class carries a certain amount of risk, as would any movement activity.  In the event that my child should be injured, I assume all responsibility and will not hold Kerith Telestai liable. *
I give my permission for my child to be photographed/recorded without his/her name attached for the purposes of promoting this program. *
Your registration is not complete without payment.  Tuition cost is $125 for all 8 weeks.  Please pay Kerith Telestai through the Venmo app (venmo.com/app) in order to secure your child's place.  (No fee if paid with your Venmo balance, debit card, or bank account; 3% fee if paid with credit card.)  Unpaid registrations will be moved to a waitlist after 24 hours.  Thank you!   :)
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