Cazateatro

Class Registration

About this Form

Use this form to register for upcoming classes. If you have questions or need help completing this form, contact us.

Class Registration

Class / Workshop

Child

Name

First Middle Last

School Name

Grade

Age

(as of August 20, 2022)

Birth Date

Gender

Male

Female

Non-Binary

Address

Street Address City State / Province / Region ZIP / Postal Code

Child’s Home Phone

Parent/Guardian – Contact Information

Parent/Guardian #1

Name

Prefix First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Work Phone

Cell phone

FAX

Occupation

Employer

Parent/Guardian #2

Name

Prefix First Last

Address

Street Address City State / Province / Region ZIP / Postal Code

Home Phone

Work Phone

Cell Phone

FAX

Occupation

Employer

Person responsible for payment:

Emergency Contact Information – Alternate Pickup/Release

Emergency Contact #1

Name

First Last

Home Phone

Work Phone

Cell Phone

Relation to child

Emergency Contact #2

Name

First Last

Home Phone

Work Phone

Cell Phone

Relation to child

Please list those people including in addition to parents/guardians who are permitted to pick up your child:

Terms of Agreement

Untitled

Facebook

Second Choice

Third Choice

Theatre Class Tuition

Price:

Credit Card

Card Details

Cardholder Name

Billing Email (for cofirmations and receipts)

Privacy Consent(Required)

I agree to the Privacy Policy