The Play Group Theatre | Class Registration Form

You have 20 minutes to complete this form.

Who should we contact in case of an emergency?

The Play Group Theatre provided over $150,000 in need-based scholarships last year. We need your to help to continue sharing PGT’s quality programs with these young actors and more in our community. Please help with a donation:

By submitting registration, you agree to PGT’s program and payment policies. Review current policies at playgroup.org/policy

First Name	Last Name	Email	Item Total $
Birthdate	Grade	School	Phone
Gender Identity MaleFemale	Primary Areas of Interest CostumeScenicTech (Lighting, Audio)	Preferred audition	Audition Time Preference
Medical Conditions

First Name	Last Name	Email	Item Total $
Birthdate	Grade	School	Phone
Gender Identity MaleFemale	Primary Areas of Interest CostumeScenicTech (Lighting, Audio)	Preferred audition	Audition Time Preference
Medical Conditions

First Name	Last Name	Email	Item Total $
Birthdate	Grade	School	Phone
Gender Identity MaleFemale	Primary Areas of Interest CostumeScenicTech (Lighting, Audio)	Preferred audition	Audition Time Preference
Medical Conditions

First Name	Last Name	Email	Item Total $
Birthdate	Grade	School	Phone
Gender Identity MaleFemale	Primary Areas of Interest CostumeScenicTech (Lighting, Audio)	Preferred audition	Audition Time Preference
Medical Conditions

First Name	Last Name	Email	Item Total $
Birthdate	Grade	School	Phone
Gender Identity MaleFemale	Primary Areas of Interest CostumeScenicTech (Lighting, Audio)	Preferred audition	Audition Time Preference
Medical Conditions

Name of Account Holder	Bank Name
Bank Routing Number	Account Number
Account Type CheckingSavingsBusiness Checking

First Name	Last Name
Email	Phone
Company	Occupation
Street Address	City
State	Postal Code
Country
Would you like to receive PGT email updates? YesNo

First Name	Last Name
Email	Phone
Company	Occupation
Street Address	City
State	Postal Code
Country
Would you like to receive PGT email updates? YesNo

Name on Card	Card Number
MM YY Code