Print and mail registration to MASTER ARTS THEATRE, 75  77th St SW, Grand Rapids, MI 49548

OR, call to register by phone using a MasterCard or VISA! (616) 455-1001

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2010 Registration Form: Fall Classes @ Master Arts

Student Name:___________________________________________________________

Sex     M     F                         Age _____                 Birth Date:____/____/____

Grade _____

Parent or Guardian's name(s):__________________________________________

Home phone: (______)_______________    Daytime phone: (______)_______________

Address:__________________________________________

City, state, Zip: __________________________________________

Email:_____________________________________

Drama
[   ] ABC's of Acting  - (Ages 4 - 6), 4:15 - 5:30 PM, 10 weeks beginning Monday, September 13     $85.00

[   ] Comedy Closet  - (Ages 7 - 11), 4:15 - 5:30 PM, 10 weeks beginning Monday, September 13     $85.00

[   ] Tricks of the Trade - (Ages 12 - 16), 4:15 - 5:45 PM, 10 weeks beginning Monday, September 13     $100.00

Payment due to secure registration:

Enclosed is my check for $________________, payable to Master Arts Theatre. I hereby release, absolve, indemnify and hold harmless the Master Arts Theatre directors and staff members; and in case of injury during normal routines and activities outlined above, I hereby waive all claims against the above. I assume all risk incidental to the conduct of these activities and transportation to and from Master Arts activities. In case of injury during camp hours call:

_______________________ at (_____)_______________ (ph#)

and/or our family physician:

_______________________ at (_____)_______________(ph#).

Parent or Guardian Signature: __________________________________   Date: ________