StagePlay Learning RegistrationSummer Camp 2025 | Spring 2025 Student's Name * First Name Last Name Date of Birth * MM DD YYYY Student's Age Student's Current School * Student's Current Grade Is your student new to StagePlay Learning? * Yes No Parent's Name * if student is under 18 First Name Last Name Email 1 * Email 2 Student or 2nd Parent Phone 1 * (###) ### #### Phone 2 Student or Parent 2 (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact * First Name Last Name Emergency Contact Phone * (###) ### #### Medical or Health Concerns Please describe any concerns that might hinder participation. Select Class * Wicked Summer Camp | Pre-K - 2nd Grade | July 7 - 12 | 9am - Noon Moana Summer Camp | Pre-K - 2nd Grade | July 14 - July 18 | 9am - Noon Wicked Summer Camp | 3rd - 5th Grade | July 7 - 12 | 1pm - 4pm BeetleJuice Summer Camp | 3rd - 5th Grade | July 14 - July 18 | 1pm - 4pm Spring Theater Class | Pre-K - 2nd Grade | Mondays, Jan 9 - Apr 28, Showcase Apr 28 | 5:30 - 6:15pm Spring Theater Class | 3rd - 5th Grade | Mondays, Jan 13 - Apr 28, Showcase Apr 28 | 6:30 - 7:15pm Spring Theater Class | 3rd - 5th Grade | Tuesdays, Jan 14 - Apr 29, Showcase Apr 29 | 6:30 - 7:15pm *NEW* Spring Theater Class for Homeschooling Programs | Tuesdays, Jan 17 - Apr 11 | Showcase Apr 11 *NEW* Tiny Stages | Tuesdays, Jan 17 - Apr 11 | 10:00am - 10:45am Student's Shirt Size YS YM YL YXL AS AM AL AXL Form of Payment * $195 due on or before the first class; $25 fee to hold space for summer theater camp only is required Check mailed to Tessitura Music, 871 S Arbor Vitae Suite 4, Edwardsville, IL 62025 Please contact Amy Prince for Venmo or Cash payment options How did you learn about our program? Social media, Google search, or were you referred by someone? If so, please include their name. Reason you chose this class? Comments Please list your questions and anything else we need to know. Thank you for registering! Your spot in StagePlay Learning summer camp is confirmed with payment. Mail check to:Tessitura Music ATTN: StagePlay871 Arbor Vitae, Suite 4Edwardsville, IL 62025