Form

STADA Registration/ Payment Form

SCHEDULE: February 3rd 2018 - June 24th 2018

Dress Rehearsal: Sat June 16 2018

Perofrmances: Sat and Sun June 23-24 2018

Use this form for new OR returning students to The Secret Theatre Academy!

If you are new, please don't forget the REGISTRATION FEE of $25 per student!

This form can be used for:

Single student taking (1-4) classes
(2-4) siblings being registered together

This form is for tuition PAID IN FULL. Still the same affordable price for the last (3) semesters! *

(1) class: $485

(2) classes -or- (2) siblings: $850 ($120 discount TOTAL)

(3) classes -or- (3) siblings: $1255 ($200 discount TOTAL)

(4) classes -or- (4) siblings: $1640 ($300 discount TOTAL)

If in need of a payment plan, please write to classes@secrettheatre.com for more information.

*PLEASE NOTE: Some class materials like costumes and dance shoes will be required purchases during semester.

STUDENT INFORMATION

Student Name *

First Name Last Name

Student Age *

Student Birthday *

/ Month / Day Year

Student E-mail *

example@example.com

Student Phone *

- Area Code Phone Number

Student Height (in feet. inches) *

Student T-shirt Size *

Youth small Youth medium Youth large Other (Indicate size in NOTES)

Student school *

Please indicate ALL classes being taken by FIRST student *

Junior Drama (ages 6-10): Saturday's 9:45 - 11am Senior Broadway Musical (ages 11-17): Saturday's 11 - 12:15pm Senior Drama (ages 11-16): Saturday's 12:15 - 1:30pm Junior Musical (ages 7-10): Sunday's 10 - 11:15am Senior TV/ Film Drama (ages 11-17): Sunday's 11:15 - 12:30pm Broadway Musical All-Ages (children/ teens): Tuesday's 3:40 - 4:40pm Broadway Tap All-Ages (beginners, children/ teens): Wednesday's 3:50 - 4:50pm

What is the student's experience in the performing arts? *

None; this is first class Took 1 class or was in 1 show and wanted to know more Took a few classes or was in a few shows already Other (please explain in NOTES)

MEDICAL/ BEHAVIORAL NOTES *

Asthma Allergies (indicate type in NOTES) Attention Deficit Disorder Autism Spectrum Disorder Dyslexia Extreme Shyness Hyperactivity Other (please explain in NOTES) N/A *

* If your child develops any medical conditions, please notify us!

NOTES

Please explain ANY extra details below, including t-shirt size, medical notes, experience level, etc.:

NOTES

IF THERE IS A SIBLING JOINING....

2nd Students Name

Age

Birthday

/ Month / Day Year

Height (in feet. inches)

T-shirt size

Youth small Youth medium Youth large Other (please write in NOTES)

Please indicate class for SECOND student

Junior Drama (ages 6-10): Saturday's 9:45 - 11am Senior Broadway Musical (ages 11-17): Saturday's 11 - 12:15pm Senior Drama (ages 11-16): Saturday's 12:15 - 1:30pm Junior Musical (ages 7-10): Sunday's 10 - 11:15am Senior TV/ Film Drama (ages 11-17): Sunday's 11:15 - 12:30pm Broadway Musical All-Ages (children/ teens): Tuesday's 3:40 - 4:40pm Broadway Tap All-Ages (beginners, children/ teens): Wednesday's 3:50 - 4:50pm

What is the student's experience in the performing arts?

None; this is first class Took 1 class or was in 1 show and wanted to know more Took a few classes or was in a few shows already Other (please explain in NOTES)

MEDICAL/ BEHAVIORAL NOTES

Asthma Allergies (indicate type in NOTES) Attention Deficit Disorder Autism Spectrum Disorder Dyslexia Extreme Shyness Hyperactivity Other (please explain in NOTES) N/A *

* If your child develops any medical conditions, please notify us!

NOTES

Please explain ANY extra details below, including t-shirt size, medical notes, experience level, etc.:

NOTES

GUARDIAN INFORMATION

Guardian Name (primary) *

First Name Last Name

E-mail *

Cellphone Number *

Second Phone Number (if applicable)

Guardian Name (secondary, if applicable)

First Name Last Name

E-mail

Cellphone Number

Second Phone Number (if applicable)

APAYMENT INFORMATION AA AAAAA

Make Payment HERE *

NEW STUDENT Registration Fee: $25 per student $ 25.00

How many new students?

(1) Class for S/S 2018 $ 485.00

(2) Students -OR- (2) Classes for S/S 2018 ($120 discount TOTAL) $ 850.00

(3) Students -OR- (3) Classes for S/S 2018 ($200 discount TOTAL) $ 1,255.00

(4) Students -OR- (4) Classes for S/S 2018 ($300 discount TOTAL) $ 1,640.00

Enter coupon

Total $ 0.00

-Terms of Service

Your class fees are a non-refundable fee. We will only consider refunds for medical reasons or other urgent situations. If you wish to seek a refund under such conditions you must apply in writing or in person to the Academy.

By registering for programs at STADA, I agree:

to follow all policies and procedures of the facility;

that there are risks and benefits of physical activity and state that your child is in condition to play;

to allow photos and likenesses of my child to be used for publicity purposes for STADA

aSURVEY a aaaaaaaaaaaaaaaaaaaaaaaa

How did you hear about our school? You may pick more than one *

Friend who is already enrolled/ previously enrolled Newspaper ad ** Online ad ** Postcard or poster ** Other source **

** Specify what newspaper, website, neighborhood of poster, "Other source".... or write N/A if heard about through friend *

Enter the message as it's shown *