CSEE Performing Arts Fall Registration CSEE REGISTRATION FALL REGISTRATION REVISED Registration Date * CSEE Performing Arts Fall Semester Classes Classes (Tues, Wed, Thurs 3PM-5PM) 1. African Dance and Drum 2. Drama and Improv 3. Visual Arts and Set Design 4. Hip-Hop Dance 1st STUDENT'S INFORMATION Student1 Name * Date of Birth * Sex * Male Female Registration & Class Fee Student #1 Payment in Full - $90 2nd STUDENT's INFORMATION Student2 Name Date of Birth Sex Male Female Registration & Class Fee Student #2 Payment in Full - $90 3rd STUDENT'S INFORMATION Sex Male Female Student3 Name Date of Birth Registration & Class Fee Student #3 Payment in Full - $90 4th STUDENT'S INFORMATION Student4 Name Date of Birth Sex Male Female Registration & Class Fee Student #4 Payment in Full - $90 5th STUDENT'S INFORMATION Student5 Name Date of Birth Sex Male Female Registration & Class Fee Student #5 Payment in Full - $90 PARENT / GUARDIAN INFORMATION Parent / Guardian Name * Relationship to Student * Street Address * City * State * Zip Code * Phone Number * Email Address * Set & Confirm New Member Password * Confirm Set & Confirm New Member Password * Total Tuition (No Registration Fees) 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 or injury as a result of participating in this virtual instructional program. Parent / Guardian Signature * Clear Date * If you are human, leave this field blank. Δ
