Acting Class Registration Form

Parent/Guardian Information

First Name

Last Name

Email

Primary Phone

Please enter digits only. Example: 1234567890

Secondary Phone

Please enter digits only. Example: 1234567890

Emergency Phone

Please enter digits only. Example: 1234567890

Acting Class Registration Form

Student Information

Student's First Name

Student's Last Name

Birth Date

Allergies

I would like to register for

Tuition Fee

$

Required Deposit

$

To register another student, please select the "Add another student" link below.

Additional Information

Is there any information you would like us know about your child or teen that will help us make their experience easier? ( i.e. Medical condition; Disability; Neurodivergent; Shy; Energetic; etc,) Please Note: This information is not required and will never affect your registration.

Additional Information

Tuition Assistance Information

Will you be applying for Tuition Assistance?

Please provide a brief narrative why you feel your child would benefit from participating in this class and a "Proof of Income" document. Documents may include: Page 1 of most recent 1040 Tax Form; Recent Paycheck Stub; SSI Letter; Legal Document stating income from government source.

Proof of Income Document

Document may include: Page 1 of most recent 1040 Tax Form; Recent Paycheck Stub; SSI Letter; Legal Document stating income from government source

Narrative

Acting Class Registration Form

Payment Details

Please select the appropriate payment option below. The "Payment Plan" option must be paid in full by third class week unless Gemini Theater makes special arrangements.

Amount Due

$

How are you making payment?

Credit Card (Full Payment)Cash or Check ($25 nonrefundable deposit per student required)Tuition Assistance ($25 nonrefundable deposit per student required)Payment Plan ($25 nonrefundable deposit per student required)

Amount Paid Today

$

Full Payment

Amount Paid Today

$

Required Deposit

Balance Due

$

Amount Paid Now

$

For Connector Processing

Billing Address

Street

City

State

Zip

5-digits only

Credit Card

First Name

Last Name

Card Number

MM

YY

Code

IMPORTANT: Select the "Review Registration" button below to view your registration and make changes before you submit payment. You must select "Confirm" on the bottom of the next screen to process your application request. Please add "Education@geminitheater.org" to your safe senders to ensure timely receipt of email confirmation and communications.

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