REGISTRATION FORM (Please complete one registration form per child.)
Only completed registration forms will be accepted. Be sure to fill in all blanks. Registrations are taken on a first come first serve basis. Space is limited. Registration is by MAIL ONLY. You will be notified if a class is cancelled or changed. No registration will be processed without payment. Partial refunds will be made with a 2 week notice of cancellation, less a $25 processing fee. Note: A $25 fee will be charged for insufficient funds.
Please PRINT
Child's Name____________________________________________________________________________
Age/DOB___________________ Grade_________________ Male Female (circle one)
Address______________________________________________________________________________
City/State/Zip__________________________________________________________________________
Parent Name__________________________________________________________________________
Cell Phone_________________________________Home Phone________________________________
Emergency Contact/Phone______________________________________________________________
List any medical conditions, allergies/special needs:
_____________________________________________________________________________________
Email:________________________________________________________________________________
Check #______________ Amount_________________
Please make checks payable to: Acting Up.
In consideration of the opportunity to participate in the classes and programs offered by We Love Acting Up LLC, I/we release & discharge Acting Up & its officers, directors, teachers, agents and Sardis Baptist Church and the Town of Matthews and Indian Trail, North Carolina from any claims, demands, liablity or damage arising from the participation of my child in any classes, programs or performances sponsored by We Love Acting up LLC classes and Summer Camp.
Signature/Date_________________________________________________________________________
____I grant Permission for the above student to be photographed in classroom environment
and on stage for marketing purpose for We Love Acting Up LLC solely, providing names are not used.
____No, thank you. I decline.