2009 Education Registration Form

Thank you for choosing to enroll your child in a Chance Theater Education Program. If you have any questions about any of the programs, or this registration form, please contact our Education Director, Tanae Beyer at (714) 777-3033 or send her an e-mail.

General Information
Student's Name*
Gender* Male     Female
Date of Birth*
School Attending*
Grade*
Parent/Guardian Name*
Mailing Address*
City*
State*
Postal Code*
Home Phone*
Work Phone
Cell Phone
E-mail Address*
 
* Required Fields
 
Does your child have any allergies, medical problems, or other special considerations we should be aware of (please list)?
   

Select the program you wish to register for:
Please view our Education Pages for detailed descriptions of our programs before choosing. If you would like to register for more than one child, you must submit multiple forms (unless it is an entire Girl Scout Troop).
Girl Scout Workshops
$15 per girl scout
Brownies: October 3
Cadettes: December 12
 
   
Promotional Code:
   
If you have any additional comments about your selection, please make them here:
       
   

Payment
Registration is not complete without payment and we will not hold a spot without payment. All payments must be made in full before the first date of the program unless specifically arranged otherwise with Tanae Beyer, Education Director.

Space for programs is limited, there may be a program that is already full. In that case, we will contact you within a week of your registration to let you know the status of your registration.
   
I will download the Supplemental Payment Form and mail it along with my payment (check or credit card) to:
    Chance Theater
Attn: Education
P.O. Box 3309
Orange, CA 92857
Please contact me so that I may pay by credit card over the phone.
I will download the Scholarship Application Form and mail it to:
    Chance Theater
Attn: Scholarships
P.O. Box 3309
Orange, CA 92857
   
If you have any questions about the education programs or this form, please call Tanae Beyer at (714) 777-3033 or e-mail her at tanae@chancetheater.com.