Registration Form

Mail this form with a $50 deposit for our Theatre  Arts Classes,
 $200 for our Summer Camp.
 Checks payable to Merrick Theatre at 2222 Hewlett Ave., Merrick, NY 11566 -Attn: JoAnne Rocca.
Credit cards - Please fill in information on bottom of registration.


Name:____________________________________________

Age:___________ T-Shirt Size____________


CAMP
Morning____ Afternoon____ Full Day _____


THEATRE SCHOOL

CLASS________________________________________



Home Tel#____________________________________

Address:_________________________________________

_________________________________________________

E-Mail:____________________________________________


In case of Emergency please contact the following person:

Name:____________________________________________

Tel#_____________________________________________


Does the student have any allergies that we should be made aware of?
_________________________

Are there any special needs that we should know about your child?_________________________________


Please be advised of the following terms of this contract:

Payment: Payment is accepted in cash, check or credit card. The payment should be made in full by the first day of class. If interested in payment plan please contact me. There is a non-refundable deposit of $50 for the Theatre Arts School and $200 deposit for the Summer Camp. 75% will be refunded if you leave by the 2nd class. 10% will be refunded if you leave by the third class. No refunds will be made after the third class has met.

Class cancellation/rescheduling: The theatre reserves the right to cancel, reschedule, or combine classes as needed based on enrollment. If a class is canceled the students will be notified by mail or phone and be given the opportunity to register for another class or request a full refund.

Sign In/Out: Students can sign themselves in. All parents/guardians are required to sign their child/children out of class in the book located on the counter of the theatre. This is mandatory for your child's safety.


Form of Payment:
Check_________ Visa/Master Card/Discover__________

Credit Card Number________________________________

Expiration Date:_______________

Signature:_______________________________________
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