Sol Children Theatre Troupe

SPRING SESSION OF CLASSES … Registration Form

STUDENT’S NAME____________________________________________________________

DATE OF BIRTH__________________________________ AGE________________________

PARENT’S (OR GUARDIAN’S) NAMES___________________________________________

HOME PHONE (____)______________PARENT’S CELL PHONE (____)_________________

BUSINESS PHONE (____)____________STUDENT’S CELL PHONE (____)_____________

MAILING ADDRESS___________________________________________________________

CITY___________________________________________ZIP CODE_____________________

PARENT’S EMAIL_____________________________________________________________

STUDENT’S EMAIL____________________________________________________________

ANY MEDICAL CONCERNS?____________________________________________________

I PREVIOUSLY TRAINED

AT____________________________________________________

I WAS REFERRED BY__________________________________________________________

I UNDERSTAND THAT NON-REFUNDABLE FULL PAYMENT MUST BE MADE

PRIOR TO STUDENT PARTICIPATING IN ANY CLASSES
....unless prior arrangements are made through the theatre office.

X ______________________________________________Signature of Parent or Guardian

...........................................................................................................................................................

FILL IN THE CLASS YOU ARE REGISTERING FOR: SPRING SESSION

TUESDAY: 3:45 4:30 5:30

WEDNESDAY: 3:45 4:30 5:30

THURSDAY: 3:30 4:30 5:30

CLASSES/TEACHERS SUBJECT TO CHANGE WITH NOTIFICATION

Please mail or email to … or drop off at …

New Students … don’t forget $50 registration fee … tuition is due at first class

Sol Children Theatre Troupe Inc. 3333 North Federal Hwy.

Boca Raton, FL 33431 561-447-8829 SolChildTroupe@aol.com

www.solchildren.org

IF PAYING BY CREDIT CARD:

CIRCLE CARD TYPE:

AM EX DISCOVER MASTER CARD VISA

TOTAL DOLLAR AMOUNT: _____________________________

CREDIT CARD NUMBER:________________________________

NAME as it appears on credit card:__________________________

FULL ADDRESS street, city, zip code:

_______________________________________________________

EXP. DATE:______ 3 or 4 DIGIT SEC. CODE: ______

AUTHORIZING SIGNATURE:

_______________________________________________________

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