420 Chartiers Avenue | McKees Rocks, PA 15136 | 412-243-6464
Acting Class Registration Form
Parent/Guardian Information
First Name
Last Name
Email
Primary Phone
Please enter digits only. Example: 1234567890
x
Secondary Phone
Please enter digits only. Example: 1234567890
x
Emergency Phone
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Acting Class Registration Form
Student Information
Student's First Name
Student's Last Name
Birth Date
Allergies
I would like to register for
Please select...
Star Spotlight Acting (Grades 3 - 5) Tuesdays | 4:30pm – 5:30pm
Rising Stars Acting (Grades 6 - 9) Tuesdays | 5:45pm – 6:45pm
Page to Stage Acting (Grades 1 – 4) Thursdays | 5:00pm – 6:00pm
Performance Workshop (Grades 2 – 6) Saturdays | 12:00pm – 3:00pm
Tuition Fee
$
Required Deposit
$
To register another student, please select the "Add another student" link below.
Additional Information
Is there any information you would like us know about your child or teen that will help us make their experience easier? ( i.e. Medical condition; Disability; Neurodivergent; Shy; Energetic; etc,) Please Note: This information is not required and will never affect your registration.
Additional Information
Tuition Assistance Information
Will you be applying for Tuition Assistance?
Please select...
Yes
No
Please provide a brief narrative why you feel your child would benefit from participating in this class and a "Proof of Income" document. Documents may include: Page 1 of most recent 1040 Tax Form; Recent Paycheck Stub; SSI Letter; Legal Document stating income from government source.
Proof of Income Document
Document may include: Page 1 of most recent 1040 Tax Form; Recent Paycheck Stub; SSI Letter; Legal Document stating income from government source
x
Narrative
Acting Class Registration Form
Payment Details
Please select the appropriate payment option below. The "Payment Plan" option must be paid in full by third class week unless Gemini Theater makes special arrangements.
Amount Due
$
How are you making payment?
Credit Card (Full Payment)
Cash or Check ($25 nonrefundable deposit per student required)
Tuition Assistance ($25 nonrefundable deposit per student required)
Payment Plan ($25 nonrefundable deposit per student required)
Amount Paid Today
$
Full Payment
Amount Paid Today
$
Required Deposit
Balance Due
$
Amount Paid Now
$
For Connector Processing
Billing Address
Street
City
State
Zip
5-digits only
Credit Card
First Name
Last Name
Card Number
MM
YY
Code
IMPORTANT:
Select the "Review Registration" button below to view your registration and make changes before you submit payment. You must select
"Confirm"
on the bottom of the next screen to process your application request.
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Contact Information
