E-mail musicaltheatrix@comcast.net Website musicaltheatrix.

com

All classes begin the week of January 9,2013 and are held at the Slayton House.
To guarantee a place in Musical Theatrix, complete the form below. A deposit of $135.00 is needed to hold a spot. Make checks payable and mail deposits to: “Musical Theatrix:” 10350 College Square, Columbia MD. 21044

Deposit: ~January: $135.00 ~February: $100.00~ March: $100.00 Please add an additional $10.00 for program fees. All other classes are paid in full at registration. *Deduct $25.00 for, “bring a friend” *Deduct $25.00 for second sibling * Students, bring a 3-ring binder, pencil, and highlighter to each class. *Note-Refunds will not be given for missed lessons or withdrawals

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Registration Form

~ $335.00 Total Deposit: ___________

Student’s Name: Parents Name: Address:

_______________________________________ Grade/Adult: ______ ____________________________________________________ ____________________________________________________
Street City Zip Code

Phone Number: Home: ___________________ Cell: ________________________ E-mail: _____________________________________________________________
I hereby understand and agree that all classes are taken at my child’s sole risk. Judy Templeton, her staff and the Slayton House are not responsible for any loss or damage resulting from any property damage or personal injury arising out of or connected with the use of the facilities or participation in the classes.

Permission is granted to Musical Theatrix to use video or photographs in advertising and publicity.
____________________________ Student/s Name ____________________________ Parent’s Signature ______ Date