Theatre Aurora Youth Group Registration 2012-2013

Theatre Aurora Youth Group Registration 2012-2013
Name (Youth)

First NameLast Name
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number (Youth)

Area CodePhone Number
E-mail (Youth)
Date of Birth
Parents/Guardians
Phone Number (Parent/Guardian)

Area CodePhone Number
E-mail (Parent/Guardian)
Disabilities/Allergies
Doctor Name/Phone Number
Health Card Number
I am Registering For:
First Time?
As part of your child’s involvement with Theatre Aurora’s Youth Group, we require a commitment from the Parents/Guardians to assist with the production. Please select what you may be able to assist with:
Parental Involvement
Comments
Should be Empty: