First Stage Children's Theater - Theater Academy

Academy Registration Form

Please submit one online Academy Registration Request per student. Online submission does not guarantee registration. Enrollment is based on availability. * Denotes required fields
How did you hear about us?
*First Name:
*Last Name:
Middle Initial:
*Gender:
Ethnicity:
*Birthday:
Age:
*Type Of School:
*School Name:
*Parent/Guardian Full Name:
*Address:
*City:	State: Zip:
*E-Mail:
*Home Phone:
*Alternate/Cell Phone:

Questions:
*I grant permission to print a promotional photo of my child for use in marketing materials:
*Is this your child's first class at the First Stage Academy?

	Summer Academy Class Selection:	Student's Grade for this upcoming fall:

Please indicate choices in order of preference. Do not choose a class unless you are willing to attend that session. If your 1st choice is not available at the time of registration, you will be registered in the next available choice noted. In the event that all choices are filled, you will be placed on a wait list for the 1st choice.
	Class Code	Dates	Location	Tuition
1st				$
2nd				$
3rd				$

Summer Academy Specific:
If enrolled, would you like to be part of a car pool list?
If this is your student's first First Stage Theater Academy class and the student is entering grade 5-12, please choose a new student orientation date:
T-Shirt Size (Each student will receive one First Stage Theater Academy T-shirt during the summer, on their first day of class)

School Year Academy Class Selection:	Student's grade for the current school year:
	New Student T-Shirt Size:
Class Code	Dates	Location	Tuition
			$
			$
			$
			$
			$
			$

Extra Merchandise:	Quantity	Size
Extra T-Shirts (Each extra T-shirt is $10)
Extra Sweatshirts (Each extra Sweatshirt is $20)

Totals:
*The tuition amount for the classes that you have selected:	$
New Student Fee (One-time application fee, add $20):	$
Extra Merchandise Total:	$
Please accept my tax deductible contribution to the Financial Aid Fund:	$
Coupon Code:
Select Discount if Applicable:
*Grand Total:	$
*Amount being paid now (Minimum $35 per class for School Year Academy; For Summer Academy, tuition must be paid in full upon registration; otherwise a $75 deposit is due at registration, and your balance will automatically be charged to your credit card on April 29, 2008):	$

Payment Information:
*Payment Method:
Card Number: No dashes or spaces (Example: xxxxxxxxxxxxxxxx)*
*Expiration Date (mm/yyyy):
Security Code (if applicable, last three digits on the back of the card in the signature line):
For School Year Academy: Automatically Charge balance on first date of class:
OR
For Summer Academy: My credit card will automatically be charged for my balance on April 29, 2008, if not paying in full today

As a condition to my child’s participation in the First Stage Theater Academy, I hereby release and hold harmless First Stage Theater Academy, First Stage Milwaukee, Inc, the Milwaukee Youth Arts Center, the Broadway Theater Center, University Lake School, and all of their respective owners, employees, agents and representatives, from and against all claims, damages and other liabilities whatsoever, including but no limited to personal injury, illness or property damage, which relate in any way to my child’s participation in the First Stage Theater Academy.

* I accept these terms & conditions

I understand that this online form does not guarantee a spot in the class. Enrollment is based on availability.

* I understand