Actor’s Playshop for Kids… Registration Form
(Please fill out an individual form for each child in the case of siblings.)
Child’s Full Name _____________________________________________________
Age ____________ Gender ___________ Nickname, if any ________________
Please check the Playshop session you want to register for:
Morning Session: 10 AM - 12 PM (grades 1 - 3) _________________
Afternoon Session: 1 - 4 PM (grades 4 - 6) ________________
Parent/Guardian Information:
Parent/Guardian’s full name __________________________________________
Address_______________________________________________________________
Best phone number(s) to reach you
_______________________________ _____________________________________
Email address _________________________________________
Emergency Contact Information:
Name _______________________________________________________________
Relationship to child ________________________________________________
Phone number(s) __________________________ _________________________
Special considerations:
Please list anything the instructor should know about your child's needs during Playshop.
_____________________________________________________________________
_____________________________________________________________________
I will send email confirmation of your child’s enrollment in Playshop upon receipt of the Registration form and fee. Thank you… Leslie
Waivers will be available for signing on the first day.
Child’s Full Name _____________________________________________________
Age ____________ Gender ___________ Nickname, if any ________________
Please check the Playshop session you want to register for:
Morning Session: 10 AM - 12 PM (grades 1 - 3) _________________
Afternoon Session: 1 - 4 PM (grades 4 - 6) ________________
Parent/Guardian Information:
Parent/Guardian’s full name __________________________________________
Address_______________________________________________________________
Best phone number(s) to reach you
_______________________________ _____________________________________
Email address _________________________________________
Emergency Contact Information:
Name _______________________________________________________________
Relationship to child ________________________________________________
Phone number(s) __________________________ _________________________
Special considerations:
Please list anything the instructor should know about your child's needs during Playshop.
_____________________________________________________________________
_____________________________________________________________________
I will send email confirmation of your child’s enrollment in Playshop upon receipt of the Registration form and fee. Thank you… Leslie
Waivers will be available for signing on the first day.