REGISTRATION FORM
CAST# enrolled in:
Student Last Name:
Student First Name:
Student Email (Optional):
Grade:
School :
Home Address:
City, State:
Zip Code:
Name of Parent / Caregiver #1:
Cell Phone Number:
Email Address:
Name of Parent / Caregiver #2:
Cell Phone Number:
Email Address:
Student’s Physician’s Name:
Health Concerns, please describe:
Allergies, please describe:
Schedule Conflicts, describe:
Liability Disclaimer/Photo Release:
Matilda Saturday Rehearsal Conflicts
RIDGEFIELD THEATER BARN KIDS SPRING 2019
STUDENT NAME_____________________ CAST #_______
PARENT NAME / PHONE # ________________________________________
Please note every Saturday rehearsal conflict that falls between 9:00AM and 1:30PM on these dates:
SAT. SEPT 7________________________________
SAT. SEPT 14________________________________
SAT. SEPT 21________________________________
SAT. SEPT 28________________________________
SAT. OCT 5________________________________
SAT. OCT 12__________________________________
SAT. OCT 19_________________________________
DRESS REHEARSALS OCT 19 THROUGH 27, KEEP THIS ENTIRE WEEK AVAILABLE