EmailMe Form - Fall 2020 Youth Registration

This form is under review for compliance requirements.
Please contact the form owner.

Student Name
First Last
Parent 1 Name
First Last
Parent 2 Name
First Last
Student Email
Parent Email
Additional Email (Optional)
Mailing lists
Address
Address Line 2
Town, Zipcode, State
Parent Phone
### - ### - ####
Student Phone
### - ### - ####
Preferred Pronouns (Ex: She/Her/Hers, He/ Him/His, They/Them/Theirs, Etc)
Student Age (Must be in grades 4-10 at the start of the program)
Grade Entering in Fall '20
Anything else we should know? Please use this space to let us know anything that would help to make this the best experience possible for your student (allergies, behavioral/ physical limitations, etc)
REGISTRATION
I am registering for: *
Annie Jr. (Full Participation)
Annie Jr. (Online Only)
My student and I have read the cast contract and Covid 19 documents on the registration page and agree to adhere to the rules and regulations set forth. *
Yes
PAYMENT
-This is a secured form
-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 ($250)
Pay $100 of my tuition now ($100) with the rest due the day of auditions
Will be submitting a need-based scholarship application for partial tuition coverage (No tuition charge will be made until scholarship has been determined)
Payment Method
Name On Card
Billing Zip Code