Theatrix Productions, Inc. Online Registration

Registration

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Referral Information

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Family Information

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Contact #1

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Student #1

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School*

Grade Level*

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Primary Doctor

Please bring bottled water to class, rehearsal and/or performance. The only ingredient should be "WATER" only. Bottle should be labeled with your name. No other beverages, candy, gum and/or food permitted in the classroom, rehearsal hall or theatre. Thanks!

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T-Shirt Size*

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Medications (Leave blank if NONE)

Primary Doctor

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Primary Doctor

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Medications (Leave blank if NONE)

Primary Doctor

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Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

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Contact #2

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Student #1

Additional Info

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