Summer '17 Stage One Act II Registration

This is the registration for the Summer 2017 Stage One Act II for children ages 10-13. Plan to complete this application in one sitting since the form will not save your information for a later time. To make filling out this form efficient, please have the participant present or his or her performing resume present. If there are any questions, please feel free to email info@3spa.org or call 201-986- 5333.

Parent/Guardian Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Home Phone Number *

Cell Phone Number *

Email Address *

Please check this box to sign up for e-mail updates on cast lists, rehearsal notes, important dates, etc.

Emergency Contact Name *

Emergency Contact Relationship to Participant *

Emergency Contact Phone Number *

Emergency Contact Secondary Phone Number *