Registration Form

Bold Fields Are Required
Attendee's Name:	Parent's Name: (put N/A if you are over 18)
Adults/Parent's Email Address: (Confirmation sent to this address ONLY)	Attendee's Email Address: (if different than adults)
Workshop Date: November 27th (FL)	Age:	Where are you from?
Address:	Home Phone: Mobile Phone:
Payment method: PayPal  Mail (Check/Money Order)  PayPal Email Address:    Payment Date:
Emergency Contact Person:	Emergency Contact Phone Number:
Background: (training, dancing, singing, acting and shows you've done)	What do you want to get out of the class?
School You Attend:	Drama/Music Teachers:
Special Skills:	Actors You Admire:
Headshot/Picture (not required: jpg, bmp, gif, png, tiff only) Comments (not required):	Security test. Please identify the pictures: Click to identify Apple Cat Clock Dog Flower Fork Hammer Key Ship Tree Click to identify Apple Cat Clock Dog Flower Fork Hammer Key Ship Tree Click to identify Apple Cat Clock Dog Flower Fork Hammer Key Ship Tree

You will be taken to the payment page when you submit this form.