Enrollment Form — Hook & Eye Theater Company

COllaborative Playmaking Enrollment Form

Please complete all required fields below. Upon form submission and approval you will receive an invoice with a payment link. Your child’s spot is not confirmed until payment has been received.

Student's Name

First Name

Last Name

Student's Date of Birth

YYYY

Student's Classroom Number and Teacher Name

Special Notes

Allergies, concerns, interests, what should we know about your child?

Parent's Name

First Name

Last Name

Phone

(###)

###

####

Additional Contact Emails

Pick Up Instructions

Name any adults who are allowed to pick up your child.

Self-Dismiss

My child does not require pick up from a parent or guardian and can self-dismiss at the end of each session.

Self Dismiss

Other Programs

Is Student also enrolled in University Settlement or Kids Orbit?

Yes

Other Program Pick Up Time

If student is also enrolled in another Wednesday program, at what time is student normally picked up from the alternative program?

Hour

Minute

Second

Pick Up Time Acknowledgment

I acknowledge that the pick up time is 5pm and that there will be a $20 fee for students picked up after 5:15

I will do my best to arrive at 5pm

COllaborative Playmaking Enrollment Form

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