YOUNG ARTISTS THEATRE

FALL 2011 CLASS ENROLLMENT FORM

Please print out form, fill out completely and mail

with check or money order to:

Young Artists Theatre

8178 Lark Brown Road #102

Elkridge, MD 21075

If enrolling additional children, please print out a separate form for each

STUDENT NAME:____________________________________________________

STUDENT’S BIRTHDATE:_______ AGE:______ SCHOOL GRADE:__________

PARENT’S NAME(S):________________________________________________

ADDRESS:__________________________________________________________

____________________________________________________________________

HOME PHONE:____________________

WORK PHONE:________________________

E-MAIL (imperative for communication during semester): _________________________________

Any special circumstances, needs or physical challenges? Please explain.

How did you hear about Young Artists?

COURSE SELECTION

COURSE NAME:______________________________DAY/TIME:___________

COURSE NAME:______________________________DAY/TIME:___________

COURSE NAME:______________________________DAY/TIME:___________

TUITION TOTAL: ______________

COSTUMING FEES: ______________

MINUS ANY DISCOUNTS: ______________

TOTAL: ______________

Please make checks or money orders payable to YOUNG ARTISTS, INC.

All payments are tax deductible

I agree to the policies stated by Young Artists on the website re: Fall Classes:

Parent Signature/Date:__________________________________________

You will receive an e-mail once your registration is processed.
Please look for a welcome letter via e-mail one week prior to class start date.

We will contact you by phone if there is any question or problem regarding your registration.