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2010 KPAS TERM 2 COURSES Cash Cheque Visa Master Card ∟∟ ∟∟

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									                                   2010 KPAS TERM 2 COURSES
                                      Term 2 - Jan 11 to May 29, 2010
STUDENT NAME & INFORMATION

First Name                                                Last Name


Home Address                                              City                                         Postal Code


Date of Birth (DD/MM/YY)                                  Age

PARENT / GUARDIAN INFORMATION

Name                                                      Relationship to Student


Home Phone                                                Alternate Phone (Work or Cell)


E-mail

EMERGENCY CONTACT INFORMATION

Emergency Contact ( if other than parent/guardian)        Relation to student


Phone Contact Info                                        Medical Care Card #

POLICIES
Payment: 100% of fees are due with registration, unless using financing payment plan for full year fees (must be
arranged in advance). All NSF cheques subject to a $25 fee. Cheques are payable to “Kaleidoscope Theatre”.
Cancellations: Refund will be made for withdrawals up to one week before the first class, less a $25 administration
charge. No refunds will be given after that date. All cancellations and refund requests must be made in writing.
Courses will run subject to a minimum registration. Should a course be cancelled by Kaleidoscope for any reason,
a full refund, minus the pro-rated value of any class already passed, will be issued.
I have read and understand these policies:
                                                                                           Signature of parent or legal guardian

PAYMENT
Amount:                                    GST included
    Cash                   Cheque                Visa        Master Card
Card Number:           ∟∟∟∟- ∟∟∟∟ -∟∟∟∟- ∟∟∟∟
Exp:                    ∟∟ / ∟∟
Name on Card:                                                    Signature:

         Registration Information and Form available on www.kaleidoscope.bc.ca
               PHONE: (250) 383-8124 ● FAX: (250) 383-8911 ● EMAIL: theatre@kaleidoscope.bc.ca
          MAILING ADDRESS: 3130 Jutland Road, Victoria BC V8T 2T3 ● WEBSITE: www.kaleidoscope.bc.ca
                 STUDIO LOCATION: Fairfield United Church, 1303 Fairfield Road (corner of Moss)
                                       COURSE SELECTION
                                   2010 KPAS TERM 2 COURSES
            Membership Matters!                                                   Office Use Only
        Annual Family Membership $25
                                                            Date Processed:
● Waive class registration fee for the whole family
                ● Vote at AGM                               Credit Card Authorization #:
                                                                                            TERM
DAY             TIME                     CLASS                  AGES




                                                                                                      DON’T MISS OUT …….REGISTER TODAY!
                                                                                              2
Mon       3:45 – 4:45 pm        Acting Basic’s                  9 – 11                  $278.25
Mon       5:00 – 6:30 pm        Acting Up!                      12 – 15                 $393.75
Mon       6:30 – 9:00 pm        Acting for Film & TV            12 – 17                     $761.25



                         SPRING BREAK CAMP
                     March 8 – 12, 2010
          Course Detail & Schedule to be announced
                        January 2010
                     Fore more information please email KPAS Principal at
                                  theatre@kaleidoscope.bc.ca

Thurs     4:30 – 6:30 pm        Advanced Acting                 9 – 11                  $556.50
Thurs     4:00 – 5:30 pm        Junior Musical Theatre          9 – 11                  $393.75
Thurs     5:30 – 7:00 pm        Senior Musical Theatre          12 – 16                 $393.75
Sat       10:00 – 11:00 am      Intro to Musical Theatre        6–8                     $278.25
Sat       11:15 am – 12:15 pm   Dynamic Drama                   6–8                     $278.25
Sat       12:30 – 1:30 pm       Budding Actors                  4–5                     $278.25


                                                                              Sub - Total
                                □ $15 Registration Fee     or    □ $25 Membership Fee
                                                                                   Total

Only cheque payments to be used with financial payment plan. Please ensure all postdated
cheques are made at time of registration and attached to this registration form.
               Great savings if you purchase Mini Family Theatre Series subsciptions…
      Save up to 24%! Book all four shows: Klondike Rag / The Adventures of Pinocchio /
                          One Man, Three Ring Circus / Beauty and the Beast.
                                   Contact McPherson Box Office (250) 386-6121
        Registration Information and Form available on www.kaleidoscope.bc.ca
              PHONE: (250) 383-8124 ● FAX: (250) 383-8911 ● EMAIL: theatre@kaleidoscope.bc.ca
         MAILING ADDRESS: 3130 Jutland Road, Victoria BC V8T 2T3 ● WEBSITE: www.kaleidoscope.bc.ca
                STUDIO LOCATION: Fairfield United Church, 1303 Fairfield Road (corner of Moss)

								
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