Student's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Is your student new to StagePlay Learning? *

Yes

No

Parent's Name *

if student is under 18

First Name

Last Name

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 *

(###)

###

####

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