Annie Jr Sign Up Form | LaGrange Piano Lessons

Parent/Guardian Name *

First

Last *

Last

Email Address *

Phone Number *

Student Information

Student's Name *

First

Last *

Last

Birthdate *

Any Allergies *

Yes

No

Please list all allergies *

Club Info:

Fall Kick-off Date: August 10^th

Rehearsal Times:

- Homeschool Drama Kids: Wednesdays 1:00-2:00pm
- Homeschool Drama Teens: Wednesdays 2:00-3:30pm
- Studio Drama: Wednesdays 3:30-4:30pm

Fall Show Dates:

- November 10^th, 7:00pm
- November 11^th, 7:00pm
- November 12^th, 2:00pm and 7:00pm

M'Liss Show Dates:

- Feb 3rd & 4th

Choose Your Drama Club

Are you already registered for Annie?

Yes

No

Purchase a Club T-Shirt ($12)

Yes

No

T-Shirt Size

Add a Show T-Shirt ($12)

Add Another Student Remove Student

Emergency Contact Information

Emergency Contact Name *

First and Last

Emergency Contact Phone Number *

Permission Slip

Please download the permission slip, fill it out, and bring it with you on the first day.

DOWNLOAD HERE

Photo and Video Release *

Yes

No

Does the instructor have permission to feature photos and/or videos of this student (never using full last name) on the studio bulletin board, website, Facebook page, and/or promotional items?

Coupon Code

Total Cost

This is the total cost for your camper and camp selections.

Credit Card *

Credit Card

Billing Address *

Billing Address

City

State/Province

Zip/Postal

Note:

Student Information

Club Info:

Emergency Contact Information

Permission Slip