Student Information

Gender *
New/Returning Student *

Introduction to Theatre: July 8-19 - Wait List Only
Theatre Immersion Level 1: July 22-Aug 2 - Wait List Only
Theatre Immersion Level 2: July 22-Aug 2 - Wait List Only
Program *


 
All participants receive a T-shirt.
Permission to Photograph *

Family Information

PRIMARY CONTACT INFORMATION

PARENT 1 CONTACT INFORMATION
Check if person is an emergency contact

PARENT 2 CONTACT INFORMATION
Check if person is an emergency contact

Emergency Information

Person(s) to Notify in an Emergency (in addition to ones checked above)
 NamePhone NumberRelationship
#1
#2
#3
Besides parents/guardians the following people have permission to pick up my child from MTW:
 NamePhone NumberRelationship
#1
#2
#3