Winter 2021 Performing Arts Registration Winter 2021 Performing Arts Class Registration Use this form to register a student for any number of our exciting winter classes! Select as many classes as you wish for one student. If you need to register more than one student, please submit a separate registration. Student's Name* First Last Student's Age*Parent/Guardian's Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* Medical/EmotionalIf 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.Select Your ClassesRemember that you can select as many as you like for one student! Click on any class or check the box next to it to add it to your registration.Performing Arts Fall 2020 Classes* 3in1 Acting/Singing/Dancing ages 7-9 Acting Comedy ages 10+ Acting Comedy ages 7-9 Broadway Obsession: Hamilton ages 10+ Broadway Obsession: Hamilton ages 7-9 Broadway Obsession: Mean Girls ages 10+ Commercials & "Self-Tapes" ages 8+ Descendants Obsession ages 7–9 Disney Extravaganza 2 ages 6-8 Mission: Manhattan ages 6-8 Monologue Workshop ages 9+ Movie Making ages 9+ How did you hear about our winter classes?Promotional Material Permission*May Elefante Music & School for the Performing Arts use photographic images and sound bites of this student for promotional material?YesNoMailing ListSign up for Elefante Music's mailing list and stay informed on future classes!No thanksTotalReview your total. By selecting the Register button you agree to charge your credit card this amount. $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name Please click REGISTER ONLY ONCE (do not double click). If you receive an error message, email email@example.com.