Act Your Best

Youth Stage Productions

P.O. Box 81, Cheltenham, MD 20623
301-458-7218 / FAX 202-595-9918
www.ActYourBest.org

Registration Form
Student’s Name: ______________________________________________________
Current Grade: ___________ Date of Birth: ___________
Parents/Guardians: _____________________________________________________
Street Address: _______________________________________________________
City, State, Zip: _______________________________________________________
Parent’s E-mail: _______________________________________________________
Please print clearly. Teachers will use email as a primary form of communication.
(Let us know if you are not email accessible.)
Phone: __________________(H) ____________________(W) _________________(Cell)

Program Number Title Tuition

TOTAL:
50% Deposit
Balance is due 3 weeks prior to class start date. All payments are non-refundable.
I have read and understand AYBYSP's policies regarding attendance and tuition.
Emergency Form: (check one) _______ On File _______ Enclosed

PAYMENT METHOD: ___Check ___ Money Order AMOUNT: $______

I give permission to ACT YOUR BEST STAGE PRODUCTIONS to
photograph my child for publicity purposes, and I am aware that
other parents may photograph and video stage shows:
❑ Yes ❑ No

_________________________________________________
Parent or Guardian Signature Required

How did you hear about us? (Please circle)

Attended before Word of Mouth Penny Saver Other:(list below)
Referred by:__________________ Other:_______________________