clap registration by 72z4fy

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									                     The Temple Theatre’s CLAP For Kids
                          Program Registration Form
Name:

School:

Address:

City:                                           MI               Zip:

Phone:

E-Mail:

Best Way to Contact:        Phone or            E-mail

Best Time to Contact:

Grade of Students: K 1st 2nd 3rd 4th 5th 6th 7th 8th
                Other: (please explain)

Number of Students: ___

Number of Teachers*: ___

Number of Adults/Chaperones*: ___
*For every 15 paid students, you are allowed one free teacher or additional adult/chaperones.
Cost is $4.00 per student/teacher/adult/chaperone

Select Show(s) attending:

Jan. 17, 2012:          10:00 am        Steve Trash - Rockin' Eco Hero

Feb.      6, 2012:      10:00 am        I Have A Dream performed by Theatre IV

Mar.      5, 2012:      10:00 am        Carpe Diem String Quartet

Mar. 28, 2012:          12:30 pm        Arts In The Concert Hall

Apr. 25, 2012:          10:00 am        Anti-Bullying with Gabe & Izzy

ADA or special requirements:



Please contact Tammy Walker at 877.754.7469 for any questions relating to ADA
access.

								
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