Willy Wonka Cast Registration

Congratulations! You got a golden ticket to a world of pure imagination! Welcome to the chocolate factory and the Elefante Musical Theater family!

Please fill out and submit the form, below:

Student's Name(Required)

First Last

Parent/Guardian's Name(Required)

First Last

Email(Required)

Please list parent/guardian email below. Please note, email will be the main method of communication with cast and families.

Address(Required)

Street Address Address Line 2 City State ZIP Code

Primary/Emergency Phone(Required)

Please list parent/guardian phone below. In cases of emergency, this number will be the primary contact.

Secondary Phone

This number will be used as a backup in case the primary contact cannot be reached. This is highly recommended, but not required.

Medical/Emotional

If you feel that our faculty could better serve the student by being made aware of any medical or emotional issues, please explain below. All such information will be kept strictly confidential.

Wonka Cast Fee Full Discount(Required)

Price:

Wonka Cast Fee Friends & Family(Required)

Price:

Wonka Cast Fee First of 2 installments(Required)

Price:

Wonka Cast Fee First of 4 installments(Required)

Price:

Wonka Cast Fee(Required)

Price:

How did you hear about this production? If you're brand new to Elefante and you were referred by an Elefante customer, please enter their first and last name and any contact info you have so we can thank them.

Mailing List Opt-In

No, thanks

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

This field is hidden when viewing the form

Date

CAPTCHA

Click “Register” ONLY ONCE.
Do not refresh your browser.

If you click “Register” and receive an error message, do not click again. Email karen@elefantemusic.com and we will check the status of your registration.