For All Registration Form 2023

Story Arts For All

Registration Form
Theater For All

Tuesdays

September 12th 2:30pm - 4:00pm

September 19th 2:30pm - 4:00pm

September 26th 2:30pm - 4:00pm

October 3rd 2:30pm - 4:00pm

October 10th 2:30pm - 4:00pm

October 17th 2:30pm - 4:00pm

October 24th 2:30pm - 4:00pm

Oct. 31st 2:30pm -4:00pm
Name and age of Participant*

First NameLast NameAge
Participant Email (optional)
Name of Parent/Guardian(Primary Contact)*
Parent/Guardian Cell Number*

Area CodePhone Number
Email*
example@example.com
Name of Parent/Guardian(Optional Secondary Contact)
Parent/Guardian Cell Number(Optional)

Area CodePhone Number
Email(Optional)
example@example.com
Emergency Contact*
Phone Number*
Mailing Address (optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies/Health & Safety Concerns?*
Tell us about the Participant*
How did you here about us?

A friendFacebookInstagramOther
Would you like receive e-mails about upcoming classes and shows?

YesNo
I hereby grant to Maple Valley Community Center & From Page To Stage Productions, its sponsors, organizers, and/or assigns ("FPTS") the irrevocable and unrestricted right to use and publish photographs (including video, photography, and performance) of my participant, or in which my participant may be included, for publication, electronic reproductions (web sites) and/or promotional materials or any other purpose and in any manner or medium. In addition, I grant my permission to alter the same without restriction; and to copyright the same. I hereby release the photographer and FPTS from all claims and liability relating to said photographs.
Parent/Guardian Signature*

Clear
*

Pay With CardPay With Cash/Check at First ClassDiscuss Scholarship OptionsUse Respite Hours
DDA Caseworker

First NameLast Name
Caseworker Email
example@example.com
prevnext( X )
Class Tuition$100.00

Total $0.00
To discuss Scholarship Options please email theater@pagetostagepro.com
Please only submit form once

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Story Arts For All

Please only submit form once