TROUPE IMAGINARIUM
HOLIDAY ACTING 101-"Sinter Klaas Under the Windmill"

sorry - this class is full

NAME:                                                 DATE:                              
AGE:                     Boy:           Girl:            
PARENT:                                                                       
PHONE:                                         CELL/WORK:                       
E-MAIL:                                                                                       
ADDRESS:                                                                                  
                                                                                                
EMERGENCY CONTACT & CELL or PHONE:                                       

                                                                                               
OTHERS AUTHORIZED TO PICKUP:                                                                                           

 

Please Initial Acceptance:

     Class choice is indicated on Page 2 and is included.

     A Check for tuition is included.

      DO USE Child’s Photo for TI Publicity   or                  Do NOT Use Child's Photo for TI Publicity
      Refunds are not offered for this class. Prorated Credit for future T.I. class registration may be offered in case of emergency withdrawal.
      I understand there is some inherent risk in any activity that uses movement and hold Troupe Imaginarium harmless from or against all claims, actions, demands, rights, damages and compensation of whatever nature, known and unknown.
      A 10% Sibling / Multiple Class / Military discount applies. Duty Station:                                            
 

Please return completed forms and checks payable to:
Beverly Hill van Joolen

219 Holland Road

Severna Park, MD 21146

or leave in Drop Box at Cato Center

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FOR USE BY T.I. ONLY:
PAID: $                by CHECK #            or  CASH          

DATE RECEIVED:                  DATE E-MAIL RECEIPT:               
CLASS FULL:              CXLD:                                                
CHECK RETURNED ON:                                                           

or APPLY TO: SESSION #         Class: