Young Theatricals Registration – Continuing Student

Student full name *

Student date of birth *

Parent or guardian name *

Parent or guardian email address *

Parent or guardian phone number *Please provide mobile or fixed line phone number

I (the student) will be making my own way to classes. *YesNoIf you select yes, we will send you a Duty of Care form for your parent/guardian to complete.

Is there anything else you would like us to know? i.e. dietary requirements, medical considerations etc.

Have any contact details changed since you last registered? *YesNo

Please detail contact detail changes below

How would you like to pay registration fees? *I would like to pay the full $235 nowI would like to pay Term 1 fees of $85 nowFees for the full year are $235 – this includes the full years tuition as well as their membership to Ipswich Little Theatre. This can be paid in full or $85 for Term 1 and $50 per term for the remaining 3 terms. Fees are due by the first day of class each term.

Payment Details *