SIGN UP FOR TRIAL CLASS

(Siblings)

By completing the form, you are registering for a Trial Class at Actors Playground. You are agreeing to attend a trial class and then let us know whether you want to officially join the class or not. The credit card entered is to hold your spot in the class but will not be charged unless you officially sign up. Thank you!

The second sibling attends for 50% off. If both siblings are taking 1 class each, tuition is $270/month total.

Student Name (Sibling 1)

First Name

Last Name

Pronouns (Sibling 1)

Student Age (Sibling 1)

Student DOB (Sibling 1)

Month/Day/Year

Student Email (Sibling 1)

Student Phone (Sibling 1)

(###)

###

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Sibling 1 Class(es) Selection

Please specify class DAY, TIME, & INSTRUCTOR

Student Name (Sibling 2)

First Name

Last Name

Student Age (Sibling 2)

Student DOB (Sibling 2)

Pronouns (Sibling 2)

Student Email (Sibling 2)

Student Phone (Sibling 2)

(###)

###

####

Sibling 2 Class(es) Selection

Please specify class DAY, TIME, & INSTRUCTOR

Students' Grade / School They Attend (if applicable)

Parent/Guardian(s) Name (If under 18)

You may add more than one, separate by comma please.

Parent/Guardian(s) Email

You may add more than one email, separate by comma please.

Parent/Guardian(s) Phone

You may add more than one, separate by comma please.

(###)

###

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Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Allergies / Medical Concerns?

Emergency Contact Name

Name/Relation

Emergency Contact Phone Number

(###)

###

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How did you hear about us?

Google, Instagram, Facebook, Referred by a Friend (tell us who!)

Card Number

Name on Card

First Name

Last Name

Expiration Date

MM/YY

CVV

Billing Zip Code

Any Notes/Questions?

SIGN UP FOR TRIAL CLASS

(Siblings)

ADDRESS / CONTACT

SITE LINKS

CONNECT WITH US

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