Mosaic Youth Theatre of Detroit Online Registration

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Please click on the Search button below, then choose the program for which you'd like to enroll.

Important Camp Information:
- When choosing your camp session, please use the grade your camper will be in the fall!
- T-shirts will be provided to each camper, however exact sizing is not guaranteed.
- The Camp Fee is $250. Scholarships are available, please note you want to be considered on your registration form. Camp balance is due on or before May 15th.

- Snacks are provided. Please plan to bring a bag lunch each day!

We are thrilled to work with you and your young artist!

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Please click on the Search button below, then choose the program for which you'd like to enroll.

Important Camp Information:
- When choosing your camp session, please use the grade your camper will be in the fall!
- T-shirts will be provided to each camper, however exact sizing is not guaranteed.
- The Camp Fee is $250. Scholarships are available, please note you want to be considered on your registration form. Camp balance is due on or before May 15th.

- Snacks are provided. Please plan to bring a bag lunch each day!

We are thrilled to work with you and your young artist!

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Please click on the Search button below, then choose the program for which you'd like to enroll.

Important Camp Information:
- When choosing your camp session, please use the grade your camper will be in the fall!
- T-shirts will be provided to each camper, however exact sizing is not guaranteed.
- The Camp Fee is $250. Scholarships are available, please note you want to be considered on your registration form. Camp balance is due on or before May 15th.

- Snacks are provided. Please plan to bring a bag lunch each day!

We are thrilled to work with you and your young artist!

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Please click on the Search button below, then choose the program for which you'd like to enroll.

Important Camp Information:
- When choosing your camp session, please use the grade your camper will be in the fall!
- T-shirts will be provided to each camper, however exact sizing is not guaranteed.
- The Camp Fee is $250. Scholarships are available, please note you want to be considered on your registration form. Camp balance is due on or before May 15th.

- Snacks are provided. Please plan to bring a bag lunch each day!

We are thrilled to work with you and your young artist!

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email*

T-Shirt Size*

School*

Grade Level in Fall*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Student Race*

Please click on the Search button below, then choose the program for which you'd like to enroll.

Important Camp Information:
- When choosing your camp session, please use the grade your camper will be in the fall!
- T-shirts will be provided to each camper, however exact sizing is not guaranteed.
- The Camp Fee is $250. Scholarships are available, please note you want to be considered on your registration form. Camp balance is due on or before May 15th.

- Snacks are provided. Please plan to bring a bag lunch each day!

We are thrilled to work with you and your young artist!

Enroll in Classes

Select Class

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies

(Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)