FALL 2019 REGISTRATION- PIPPIN!
Welcome to Broken Leg Productions, we are so excited for the season ahead and that you will be joining us. Once your registration is complete you will receive a confirmation email with receipt of payment and welcome e-mail from us, both within 48 hours. Feel free to contact us at firstname.lastname@example.org with any questions you may have.
Student Preffered Pronouns (He/Him) (She/Her) (They/ Them), etc.
Parent 1 Name
Parent 2 Name
Additional Email (Optional)
Please only e-mail me information pertaining to this program
Please e-mail me regarding all BLP youth programming
Please add me to the BLP general mailing list
Address Line 2
Town, Zipcode, State
Student Grade (Must be entering grades 8-12 at the begining of the 19-20 school year)
By checking this box, both student and parent understand that both 'Pippin' contains some mild adult language and subject matter and give consent for their child to participate.
How did you hear about us?
I am registering for:
Audition night will be quite important for each session. Please make sure to note when it is (September 24th with callbacks on September 26th)
Yes, we know when our audition date is and we are able to attend.
We know when our audition date is and have a conflict but will coordinate an alternative audition date or a video submission with email@example.com
My student and I have read the cast contract document on the registration page and agree to adhere to the rules and regulations set forth.
Anything else we should know?
-This is a secured form
-All registrations received before 4/1 will receive an automatic $25 discount
-Please allow 48 hours for payment to process
-When processed you will receive a confirmation from Square (the company we use to process credit cards)
I would like to:
Pay my full tuition now ($350)
Pay $100 of my tuition now with the rest due the day of auditions($100 Now, Balance of $250)
We will be submitting a need-based scholarship application (No charge will be made until scholarship has been determined)
Name On Card
Expiration Date (mm/yy)
CVV (3 or 4 Digit code found on the back of your card)
Billing Zip Code
Parent support is wonderful but not required, please let us know if your are interested in helping behind the scenes!
I would be interested in helping with the following areas (check as many as apply)
Set construction and painting
Board of Directors
Front of House