Prairie Music & Arts Drama Registration Form

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Prairie Music & Arts Drama Registration Form

The Drama Program runs for 12 weeks in the Fall and the Winter sessions. The Drama program is for students in Grades 3-6.

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* Indicates required question

Last Name of Student *

Your answer

First Name of Student *

Your answer

Home Phone *

Your answer

Parent #1 First and Last Name *

Your answer

Parent #1 Phone (Cell Phone) *

Your answer

Parent #2 First and Last Name

Your answer

Parent # 2 Phone (Cell Phone)

Your answer

Email Address *

Your answer

Student's Date of Birth *

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YYYY

Student's Age/Grade in Fall *

Choose

3

4

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6

School Attending Fall

Your answer

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