San Pedro Playhouse Online Registration

Registration

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Thank you for your interest in the Playhouse Conservatory! Please complete the following form below to register for classes or camps. You will be required to enter your debit/credit card number in order to enroll. Your card will not be charged until fees are posted on the 1st of each month. Parents/Guardians: please list at least one, and up to three, individuals who are authorized to pick up your child under the field "Parent-approved pick-up name."

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info *

Parent-approved pick-up name*

Parent-approved pick-up name

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (share only if comfortable or need accomodations)

Special Needs (share only if comfortable or need accomodations)

Allergies

Medications

Immunizations YN

Immunization Notes

Student's Ethnicity

Student's Race

Student's Pronouns

Please click on the Search button below to choose your class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (share only if comfortable or need accomodations)

Special Needs (share only if comfortable or need accomodations)

Allergies

Medications

Immunizations YN

Immunization Notes

Student's Ethnicity

Student's Race

Student's Pronouns

Please click on the Search button below to choose your class.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (share only if comfortable or need accomodations)

Special Needs (share only if comfortable or need accomodations)

Allergies

Medications

Immunizations YN

Immunization Notes

Student's Ethnicity

Student's Race

Student's Pronouns

Please click on the Search button below to choose your class.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (share only if comfortable or need accomodations)

Special Needs (share only if comfortable or need accomodations)

Allergies

Medications

Immunizations YN

Immunization Notes

Student's Ethnicity

Student's Race

Student's Pronouns

Please click on the Search button below to choose your class.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Transportation

Disabilities (share only if comfortable or need accomodations)

Special Needs (share only if comfortable or need accomodations)

Allergies

Medications

Immunizations YN

Immunization Notes

Student's Ethnicity

Student's Race

Student's Pronouns

Please click on the Search button below to choose your class.

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

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)

Who is your employer?

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

Payment Information

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)

Who is your employer?

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

Payment Information

Required Policies

(Show-Hide Details)