Print and mail registration to MASTER ARTS THEATRE, 75 77th St SW, Grand Rapids, MI 49548
OR, call to register by phone using a MasterCard or VISA! (616) 455-1001 or 1-800-455-5003
—————————————————— ——————————————————
2008 Registration Form: Hudsonville Winter Classes
Student Name:___________________________________________________________
Sex M F Age _____ Birth Date:____/____/____
Entering grade _____
Parent or Guardian's name(s):__________________________________________
Home phone: (______)_______________ Daytime phone: (______)_______________
Address:__________________________________________
City, state, Zip: __________________________________________
Email:_____________________________________
[ ] Act I - Scene 4 - Start up Acting (Ages 7 - 9)
$95
10 Weeks beginning, Tuesday, Sept
16, 3:45 - 5:00 PM
[ ] Act II - Scene 4 - Acting Today (Ages 10 - 12)
$95
10 Weeks beginning, Tuesday, Sept
16, 3:45 - 5:00 PM
[ ] Act III - Scene 4 - Monologues (Ages 13 - High School)
$110
10 Weeks beginning, Tuesday, Sept
16, 3:30 - 5:00 PM
Payment due to secure registration:
Enclosed is my check for $________________, payable to Master Arts Theatre. I hereby release, absolve, indemnify and hold harmless the Master Arts Theatre directors and staff members; and in case of injury during normal routines and activities outlined above, I hereby waive all claims against the above. I assume all risk incidental to the conduct of these activities and transportation to and from Master Arts activities. In case of injury during camp hours call:
_______________________ at (_____)_______________ (ph#)
and/or our family physician:
_______________________ at (_____)_______________(ph#).
Parent or Guardian Signature: __________________________________ Date: ________