REGISTRATION FORM

Fall Session 20__

Winter Session 20__
Summer Events 20__
Summer Camps 20__

Please print!
Students First Name ____________________________ Last Name ______________________________
Date of Birth ______________Age ____ M ____ F ____ School ______________________Grade ______
Parent/Guardian Name(s)
___________________________________________________________________________________
Street Address/Apt. # ___________________________________________________________________
City _________________________________________________State _____ Zip __________________
Home Phone ____________________________Cell Phone _____________________________________
Work Phone ____________________________ Email Address __________________________________

Emergency Contact:
Name: _________________________ Relationship ___________________ Phone _____________________
I understand that in the event of an emergency PRT/SoDA will make every effort to reach me but if that is not possible,
they have my permission to seek appropriate medical care through Community Hospital of Monterey Peninsula. I understand that Pacific Repertory Theatre and SoDA will not be held responsible for any medical expenses for me or my child.
Parent/Guardian Signature
_________________________________________________________________

Standards of Student Behavior Please read and sign this agreement:

I understand and agree that I am expected to behave in a respectful manner towards all SoDA instructors, students, materials, and locations at all times. My right to attend class(es) can be revoked should I not adhere to a
proper behavior code. Student Signature __________________________________Date ______________
Photo/Video Release For valuable consideration received, I hereby grant to SoDA and its legal representatives
and assigns, the irrevocable and unrestricted right to use and publish photographs/videos of my child in class at
SoDA, for editorial trade, advertising and any other purpose and in any manner and medium; and to alter the
same without restriction. I hereby release SoDA and its legal representatives and assigns from all claims and liability relating to said photographs/videos. Parent/Guardian Signature ___________________________________

How did you hear about SoDA?

Newspaper ___ School ___ Mail ___ Library ___ Friend (Name) ________________________ Email ___ Other ____________________

SoDA REGISTRATION PAGE 2

Student Name: _______________________________________

CHILDRENS CORE CLASSES (10 weeks)

Class Fee

PRE-MUSICAL THEATRE (T 2:45-3:30, Sept 17-Nov 19)

$200

BEGINNING THEATRE (TH 3:30-4:30, Sept 19-Nov 21)

$200

INTERMEDIATE THEATRE (W, 3:30-4:30, Sept 18-Nov 20)

$200

ADVANCED THEATRE (W, 4:30-5:30, Sept 18-Nov 20)

$200

ELECTIVES

Class Fee

BROADWAY DANCE (M, 3:30-4:30, Sept 16-Nov 18)

$200

IMPROV COMEDY (TH, 4:30-6, Sept 19-Nov 21)

$200

PLAY PRODUCTION (T, 3:45-5:30, Sept 17-Nov 19)

$300

MAKE A MOVIE I (Sat, 9am-10:30am, Sept 21-Nov 23)

$300

MAKE A MOVIE II (Sat, 11am-12:30pm, Sept 21-Nov 23)

$300

AUDITION PREP (Starts late October, 5 weeks, dates & times

$100

Subtotal:

Subtotal:

TBA subject to PacRep announcement of production schedule)

FALL BREAK CAMP

HALLOWEEN PICTURE SHOW (M-F, 10-3, Oct 14-18)

$250

Subtotal:

ADD ALL SUBTOTALS

Add Registration Fee $20.
(new students only)
Add Gift Donation to SoDA
Scholarship Fund

TOTAL DUE:

Method of Payment:

MasterCard

Visa

Check

Cash

Online

Credit Card #

Name On Card: ___________________________________________________________________

Exp. date

SCHOLARSHIP APPLICATION

In support of performing arts and as a community service to children who wish to participate in
classes/workshops sponsored by Pacific Repertory Theatres School of Dramatic Arts we offer partial
tuition assistance. Your scholarship application will be considered based on available funds and your
need. Please complete the entire form below.
CLASS(ES):_________________________________________AMOUNT REQUESTED ________
STUDENT NAME:_____________________________________________BIRTHDATE:_______
GRADE:_____AGE:_____SCHOOL___________________________MALE______FEMALE_____
In order to make it possible for P.R.T./SoDA to obtain grants we need the following information:
Check one (optional): African American____ Hispanic/Latino___ Native American____ Asian/
Pacific____ White/Other____
1. List performing arts experience that you have had including # of years, teacher and city:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
2. Are you willing to consistently attend and participate in the class or workshop that is covered
by this scholarship?
______________________________________________________________________
3. Please tell us about yourself and why you would like to be considered for tuition funding (both
the student and parent or guardian should respond to this request). You may use the
area below and/or the back of this page.
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
STUDENT SIGNATURE:______________________________DATE:______________________
PARENTS NAMES:______________________________________________________________
ADDRESS:____________________________________________________________________
HOME PHONE______________WORK PHONE:________________E-MAIL________________
Pacific Repertory Theatres School of Dramatic Arts is a nonprofit organization