YOUNG ARTISTS THEATRE

WINTER 2008 CLASS ENROLLMENT FORM

Please print out form, fill out completely and fax with

credit card number/expiration date to:

301-604-2845

or mail with check, money order, or credit card information to:

Young Artists Theatre

11200 Scaggsville Road #127

West Laurel, MD 20723

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.

For VISA OR MASTERCARD, please fill out the spaces below

NAME ON CARD:____________________________SIGNATURE:_______________________

ACCOUNT #___________________________________________ EXP. 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.