EmailMe Form - Fall 2018 Audition Intensive Registration

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

Participant Name
First Last
Parent 1 Name (if under 18)
First Last
Parent 2 Name (if under 18)
First Last
Student Email
Parent Email
Additional Email (Optional)
Mailing lists
Address
Address Line 2
Town, Zipcode, State
Parent Phone
### - ### - ####
Student Phone
### - ### - ####
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: *
All Three Days ($60)
Day 1- Audition Prep- Oct 23- $25
Day 2- At the Audition- Oct 30- $25
Day 3 - CB/ Post/ Mock- Nov 6- $25
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. *
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)
Payment Method
Name On Card
Card Number
Expiration Date (mm/yy)
CVV (3 or 4 Digit code found on the back of your card)
Billing Zip Code