Registration Form for
SUMMER DRAMA WORKSHOP 2011
Sponsored by CREATIVE YOUTH THEATER 

Name ____________________________________________Age  _____________Gender______

Complete Address and  City______________________________________________________________

Home Phone__________________ Parent's Cell Phones ______________________________________

Email Addresses ________________________________________________________________

Parent's names ____________________________________________________________

Emergency Names and Numbers:

Name _____________________________________Contact Number_______________________

Name ____________________________________Contact Number _____________________

You are registering for the play   BYE BYE BIRDIE  ________________

A little bit about you:

School ___________________________ Grade __________________________Height _______________________

Tell me about your experience on stage (anything?...music, drama, etc.):

Please check the things that apply to you:

I want a big part ______   I will be okay with a smaller part _______

I can sing alone________  I can sing with a group ________I can dance __________

I can talk with accents _______ I can talk loudly______ I can memorize lines easily______

I'm ready to learn new things _______ I'm kind of new at this and am nervous _______

Anything else you want to tell me about YOU!! (talents, experiences, etc.)

Please send this form in with the deposit of $35 and the Participation Agreement
to:     Christie Miller, Creative Youth Theater Director
2818 Martin Road          Bellingham, WA  98226
(Balance paid on the first day of the workshop;
Deposit is non-refundable after June 1)

Questions:  360-966-0203     or director@creativeyouththeater.com