Community Education - current class catalogs Project Power - Winter 2015-16 | Page 23

Winter registration form
(ONE FORM PER PERSON / THIS FORM MAY BE REPRODUCED)

Participant/Staff information: (No participant substitution without prior notice.)
Participant name: _____________________________________________________________ Phone: _______________________________
Address: __________________________________________________________

City: ________________________ Zip: ______________

Email: ____________________________________________________ (for class confirmation) Birth date: ________ / ______ / __________
Month

REQUIRED - Legal guardian/Emergency contact:

Day

Year

Guardian name: ________________________________________________ Phone: ____________________________

Music &
theatre

Participant ______ $29
Participant ______ $5
Participant ______ $45
Participant ______ $29
Participant ______ $29
Participant ______ $29

Bunny