Shakespearience Registration Select a program type to begin your registration.
Program Type:
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.
Parent's/Guardian's Name*:
Student's Name*:
Date of Birth*:
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 Summer Program. Yes
Apt:
I hereby approve and give permission for my son/daughter to attend the Shakespearience After Hours Program. Yes