stage doors
EDUCATION SERIES 2022-2023
REGISTRATION FORM
INFORMATION
School/Family
Teacher/Contact
one name only, please
School Address
City
State
Zip
School Phone
Home Phone
Fax
E-Mail
Grade Level(s) Attending
School District / County
School Type:
Public
Private/Parochial
Home School/Family
Childcare Center
Please indicate the number of vehicles requiring parking at the Weidner Center:
Bus
Car
Would you be interested in having a teaching artist visit your classroom?
Yes
No
Maybe
Would you be interested in the Extend the Day program if it is added in conjunction with these performances?
Yes
No
Maybe
Additional Information
PERFORMANCES
Performance
Date
Time
(indicate preference)
# Paid
Students
Student
Price
# Paid
Chaperones
Chaperone
Price
# Comp*
Chaperones
Payment
Due**
Total
Due
EXAMPLE
Th 12/01/22
10am
12:30pm
50
$7
1
$7
3
11/01/22
$357