Name of Workshop:_________________________________________
Dates of Workshop:__________________________________________
Student's name:_________________________________________________
Parent's name:__________________________________________________
Parent's email:__________________________________________________
Address:_________________________________________________________
Home Phone number:_______________________________________________
Cell Phone number:_______________________________________________
Student's date of birth:_________________________________________
Allergies/Special needs:_________________________________________
Emergency Contact Name and Phone:________________________________
Comments:________________________________________________________
Are you a current CTA member? Yes_____ No_____
All participants must be current members of CTA. A $10 individual or $20 family membership is paid annually and is valid from July 1 through June 30. If you are unsure of your membership status you can inquire at info@childrenstheatreofannapolis.org.
Workshop Tuition Paid $_________
Membership Dues Paid $__________
Total paid $_________________
Check #:____________________
Please make checks payable to CTA and mail with completed form to:
Children's Theatre of Annapolis
P.O. Box 1785
Annapolis, MD 21404.
You may also email this form to workshops@childrenstheatreofannapolis.org and send your payment separately. All payments must be received prior to the workshop start date and have the participant's name and workshop name notated on the check. If you have any further questions, please email info@childrenstheatreofannapolis.org or call 410-757-2281.