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BTW
Workshop/Lesson Registration Form
Participant Information (Student)
First Name
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Last Name
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Gender
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M
F
Birth Date
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Grade
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-
preschool
Kindergarden
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
School:
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School Location (city, state):
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Student email address
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I would like to register my child for (Course Descriptions at BTWSTARS.com):
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Voice Lessons - 45 minute private lessons
Dance - private lessons
Spotlight On Series - Grades 3-8 (beginning Jan 13)
Private Acting or Audition Coaching
If registering for Voice lessons, I have availability:
Mondays
Tuesdays
Wednesdays
Thursdays
If registering for Voice lessons, I prefer:
John Zupan
Richard Adams
Cathryn Basile
Christy Tarr-McVey
Tuition (Non-Refundable):
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Spotlight On... - $400 check
Spotlight On... - $425 credit card
Voice Single Lesson $90 check
Voice Single Lesson $95 credit card
Voice Lessons Block of 5 - $425 check
Voice Lessons Block of 5 - $438 credit card
Voice Lessons Block of 10 - $750 check
Voice Lessons Block of 10 - $775 credit card
Dance Lessons - Single $90 check
Dace Lessons - Single $95 credit card
Dance Lessons Block of 5 - $425 check
Dance Lessons Block of 5 - $438 credit card
Dance Lessons Block of 10 - $700
Dance Lessons Block of 10 - $720
Private Acting or Audition Coaching $80 check
Other amount
Private Acting or Audition Coaching $85 credit card
Household / Adult Primary Contact
Relationship to Student:
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Self
Mother
Father
Guardian
Other
Other
First Name
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Last Name
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Address 1
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Address 2
City
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State
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Zip
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Phone
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Alternate Phone
Parent Email Address
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Where or from whom did you learn about our program?
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