Dare to Dream Theatre Academy Registration Form

Unless otherwise notes, Academy Classes will be held at:

Dare to Dream Theatre
634 N 10th St
Manitowoc, WI, 54220
http://www.daretodreamtheatre.com

PLEASE NOTE: When registration is filled, you will be placed on a waiting list

Student Information

First Name

Last Name

Sex

Birth Date

Grade fall 09

Which School Do you attend?

E-mail address

Please list any previous theatre experience.

Class information

Please mark which classes you are registering for.

The Actor in You Series Level 1 (K-1)

The Actor in You Series Level 2 (grade 2-3)

The Actor in You Series Level 3 (grade 4-5)

The Actor in You Series Level 4 (grade 6-9)

The Actor in You Series Level 5 (grade 10-12)

The First Steps Program (age 3-6)

The Stages Program (age 7+)

The Triple Threat Program (grades 5-10) Audition required

Please mark the top 3 time/dates you would prefer for your class(es).

Household / Adult Primary Contact

Relationship to Participants:

First Name

Last Name

Address 1

Address 2

City

State

Zip

Phone

Alternate Phone

Email Address

Indicates Response Required