Registration Form

Please Fill out this form in it's entirety! You/your child are not registered until Liability Waiver and Code Of Conduct Forms are signed

Student First name

Student Last Name

Student Date of birth

Month

Day

Year

Classes Registering For

Parent/Guardian First and Last Name (if adult just put N/A)

Parent/Guardian/Adult Student Email

Parent/Guardian/Adult Student Preferred Phone #

Country/Region

Address

City

Zip / Postal code

If you would like to register a sibling, please put their Name, Age and classes registering for in this spot

How did you hear about us?

I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER PARTICIPATION, AGREEMENT, LIABILITY WAIVER, AND POLICY ACKNOWLEDGEMENT,

https://www.imagineperformingartscenter.org/liabilitywaiver

By signing, I acknowledge that I have read, understood, and agree to all the terms and conditions stated in this agreement.

I declare that I have read and acknowledge the IMAGINE PERFORMING ARTS CENTER STUDENT CODE OF CONDUCT

https://www.imagineperformingartscenter.org/codeofconduct

By signing, I confirm that I have read, understood, and agree to the student code of conduct, and I am aware of the consequences of not adhering to it.

Emergency Contact Name

Emergency Contact Phone

Registration Fee

Registration Fee for One Student$25

Registration Fee For Two Students$50

I would like to donate to another child's tuition

Register For Classes!

Registration Form