Registration Reservation Form

Enroll now in Acting Up CDA for:

Afterschool Care or Individual Classes

After School Care Monthly recuring Tuition is $260 (taxes included)
Individual Creative Drama Classes are $65 (taxes included)
We require a one time annual $50 Non-refundable
registration fee per child to reserve a spot for each child.

Click Submit at the end of the form to send your Reservation today.
To clear the form, click Reset.

Parent or Legal Guardian Information:
Full Name (as it appears on your Credit Card)
Address
City                               State              Zip
  
Primary Phone       Secondary Phone    Work Phone
  
E-mail
Number Of Children You Are Registering
 1   2   3   4
1st Child's Information:
First Name                                   Last Name
 
Age                              Birthday        Male/Female
  
Payment
 $50 Registration  After School Care  Creative Drama Class
Comments
2nd Child's Information:
First Name                                   Last Name
 
Age                              Birthday        Male/Female
  
Payment
 $50 Registration  After School Care  Creative Drama Class
Comments
3rd Child's Information:
First Name                                   Last Name
 
Age                              Birthday        Male/Female
  
Payment
 $50 Registration  After School Care  Creative Drama Class
Comments
4th Child's Information:
First Name                                   Last Name
 
Age                              Birthday        Male/Female
  
Payment
 $50 Registration  After School Care  Creative Drama Class
Comments
Emergency Contact Information:
First Name                                   Last Name
 
Home Phone          Cell Phone             Work Phone
  
E-mail                          Relationship to Child