Junior High Registration

James & The Giant Peach Junior
Junior High Show Online Registration Form

* Indicates required field

Cast Member *

1st child *

Grade in Fall 2017 *

T-shirt Size *

2nd child in the same family *

Grade in Fall 2017 *

T-shirt Size *

3rd child in the same family *

Grade in Fall 2017 *

T-shirt Size *

4th child in the same family *

Grade in Fall 2017 *

T-Shirt Size *

Parent/Guardian Names *

Cell Number to be used for Group Text *

Secondary Phone Number *

Emergency Contact Person *

Phone Number *

Relationship *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Payment by November 8th *

Email *

I hereby release Gibson County Youth Theatre of liability for any accident/injury my child may incur while participating in GCYT Activities. I give permission for my child's picture/video/likeness/voice to be used in promotional media.

Liability Waiver *

I accept

Please list any comments, special health or behavior concerns: *

Submit

YOU MUST CLICK SUMBIT ABOVE PRIOR TO MOVING ON TO PAYMENT.
Payment is a separate step.

SNAIL MAIL OPTION

James & The Giant Peach Registration Form & Calendar

Print the form above and mail it with payment to:

Gibson County Youth Theatre
Kathy Evans, Treasurer
P.O. Box 247
Patoka, IN 47666

ONLINE PAYMENT

For payment through PayPal, Click the "Buy Now" button:

James & The Giant Peach JuniorJunior High Show Online Registration Form

James & The Giant Peach Junior
Junior High Show Online Registration Form