EmailMe Form - TK BOOTCAMP REGISTRATION

Please indicate date of Bootcamp that you are applying for.
Name *
First Last
AGE *
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
How many years have you studied tap? *
2-3 years
3-4 years
4 or more years
How did you hear about Tap Kids?
Name of current teacher *
Teacher's Email Address *
Parent's name *
First Last
Parent's Email *
Parent's Contact *
### - ### - ####
T-Shirt Size
PAYMENT
Payments should be by PayPal unless this is not an option. After completing the PayPal process, you will receive an e-mail which included a transaction ID. Please paste this ID into the field below. If you are unable to pay via PayPal, please contact lisa@nystage.com for further instructions.
PAYPAL TRANSACTION ID *
I agree to release the workshop producers, New York Stage Originals, the workshop teachers, staff, sites, studios and showcase theatre from any and all claims in the event of a personal injury, or property lost sustained during this event. I also authorize New York Stage Originals to use the participants image for Tap Kids advertising and promotional purposes.
*
I AGREE
PAY NOW: Paste this link into your browser to find Paypal payment link.
https://www-newyorkstage-com.checkout.weebly.com/?cart=527beb8e991f3