Shakespearience Registration
Select a program type to begin your registration.

Program Type:

In-school
Summer
After Hours

School Name*:

Address*:

City*:

Postal Code*:

School Phone*:

Alternate Phone*:

Contact Email*:

What play would you like the actors to look at?

What grade level at your school is studying this play?

Other comments or questions:

Please indicate three choices of dates and times when
you would prefer to host the seventy-five minute workshop.
One may book up to the end of the third week of June.

1.
2.
3.

Parent's/Guardian's Name*:

Student's Name*:

Date of Birth*:

Address*:

City*:

Postal Code*:

Home Phone:

Work Phone:

Cell Phone:

School*:

Grade*:

Contact Email*:

Does your child have any medical conditions?
YesNo

If yes, please give additional information.

Does your child have any allergies?
YesNo

If yes, please note the source of the allergy.

In case of an emergency and Parent/Guardian cannot
be reached, please provide at least one local contact person:

Name*:

Relationship to Child*:

Phone Number*:

I hereby approve and give permission for my son/daughter
to attend the Shakespearience Summer Program.
Yes

Parent's/Guardian's Name*:

Student's Name*:

Date of Birth*:

Address*:

Apt:

City*:

Postal Code*:

Contact Email*:

Home Phone:

Work Phone:

Cell Phone:

School*:

Grade*:

Does your child have any medical conditions?
YesNo

If yes, please give additional information.

Does your child have any allergies?
YesNo

If yes, please note the source of the allergy.

In case of an emergency and Parent/Guardian cannot
be reached, please provide at least one local contact person:

Name*:

Relationship to Child*:

Phone Number*:

I hereby approve and give permission for my son/daughter
to attend the Shakespearience After Hours Program.
Yes

Contact Us

Marvin Karon
Executive Director

Phone: 416-845-1407
Fax: 416-502-9970
Email: mkaron@shakespearience.ca

Shakespearience Performing Arts
222 Jackson St. West., Ste 501
Hamilton, Ontario
Canada
L8P 4S5

Shakespearience thanks the support of

Our Sponsor