Mini Musical Registration Forms

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WILLY WONKA Registration Form- Session 4

Actor First Name

Actor Last Name

Gender

Height

Email

Phone

AGE:

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Name of registering Parent or Guardian First Primary Contact)

Emergency Name & Phone Number

I understand there is a participation fee and that registration is limited. I also understand that I am not registered until the participation fee has been paid. Participation Fee is $65 Per person.

YES

NO

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding.

YES

NO

I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact.

YES

NO

Parent/Guardian ELECTRONIC SIGNATURE

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Willy Wonka Participation Fee

$65

WILLY WONKA Registration Form- Session 5

Actor First Name

Actor Last Name

Gender

Height

Email

Phone

AGE:

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Name of registering Parent or Guardian First Primary Contact)

Emergency Name & Phone Number

I understand there is a participation fee and that registration is limited. I also understand that I am not registered until the participation fee has been paid. Participation Fee is $65 Per person.

YES

NO

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding.

YES

NO

I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact.

YES

NO

Parent/Guardian ELECTRONIC SIGNATURE

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Willy Wonka Participation Fee

$65

WILLY WONKA Registration Form- Session 6

Actor First Name

Actor Last Name

Gender

Height

Email

Phone

AGE:

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Name of registering Parent or Guardian First Primary Contact)

Emergency Name & Phone Number

I understand there is a participation fee and that registration is limited. I also understand that I am not registered until the participation fee has been paid. Participation Fee is $65 Per person.

YES

NO

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding.

YES

NO

I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact.

YES

NO

Parent/Guardian ELECTRONIC SIGNATURE

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Willy Wonka Participation Fee

$65

WILLY WONKA Registration Form- Session 7

Actor First Name

Actor Last Name

Gender

Height

Email

Phone

AGE:

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Name of registering Parent or Guardian First Primary Contact)

Emergency Name & Phone Number

I understand there is a participation fee and that registration is limited. I also understand that I am not registered until the participation fee has been paid. Participation Fee is $65 Per person.

YES

NO

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding.

YES

NO

I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact.

YES

NO

Parent/Guardian ELECTRONIC SIGNATURE

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Willy Wonka Participation Fee

$65

WILLY WONKA Registration Form- Session 8

Actor First Name

Actor Last Name

Gender

Height

Email

Phone

AGE:

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Name of registering Parent or Guardian First Primary Contact)

Emergency Name & Phone Number

I understand there is a participation fee and that registration is limited. I also understand that I am not registered until the participation fee has been paid. Participation Fee is $65 Per person.

YES

NO

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding.

YES

NO

I declare that I am the parent or legal guardian of the above named child. In the event my child is injured or should require medical attention, I hereby request that you contact me or our emergency contact.

YES

NO

Parent/Guardian ELECTRONIC SIGNATURE

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Willy Wonka Participation Fee

$65

Cedar City

Children's Musical Theatre

WILLY WONKA Registration Form- Session 4

WILLY WONKA Registration Form- Session 5

WILLY WONKA Registration Form- Session 6

WILLY WONKA Registration Form- Session 7

WILLY WONKA Registration Form- Session 8

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