Old Registration Form Online Registration Form Registration Date * Student Information Student's Full Name * Date of Birth * Age * Sex * Male Female School * Grade * Medical Alerts Ethnicity of Student * Hispanic or Latino Not Hispanic or Latino Race of Student * American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Pacific Islander White Multi-Racial Please check all that apply Registration Fee New Student - $60.00 Returning Student - $40.00 Siblings - $25.00 Already Registered - Just paying tuition - $0.00 Tuition Fees - Tuition Assistance Available for those who qualify - Please complete Form and contact us for additional information / Payment Arrangements Available 1 Class - $250 2 Classes - $350 3 Classes - $450 4 Classes - $525 5 Classes - $600 Sibling Tuition Fees - Siblings 25% discount per class No Siblings - $0.00 1 Class - $187.50 2 Classes - $262.50 3 Classes - $337.50 4 Classes - $393.75 5 Classes - $450.00 Choose Classes * IR Repertory (By Audition Only) - Mondays 4:30 - 6:30 African Drums - Mondays 4:30 - 6:30 African Dance - Mondays 5:30 - 6:30 Acting - Mondays 5:30 - 6:30 Ballet PreK->2nd Grade Tuesdays 3:30 - 4:30 Ballet PreK->2nd Grade Tuesdays 4:30 - 5:30 Tap - Tuesdays 4:30 - 5:30 Ballet - Tuesdays 5:30 - 6:30 Keyboard - Thursdays 4:30 - 5:30 Vocal/Songwriting - Thursdays 5:30 - 6:30 Class Registration Additional Class Guitar - Tuesdays 4:30 - 5:30 Registration + Tuition Total Parent / Guardian Information Parent / Guardian Name * Relationship to Student * Street Address * Apt. # City * State * Zip Code * Preferred Phone Number * Alternate Phone Number * Email Address * Emergency Contact Name * Phone Number * Relationship to Student * Returning Students Date of Last Registration Release of Responsibility In giving my consent, I further release YOUTH THEATRE INTERACTIONS, INC. (YTI) and its administrators, instructors, or any person acting on behalf of YTI of any responsibility for accident, not due to the negligence of said personnel. Parent / Guardian Signature * Clear Date * If you are human, leave this field blank. Δ