Register For After School Drama

3Pics

REGISTER FOR AFTER-SCHOOL DRAMA!

PLEASE FILL OUT the online registration form below.

We currently have After-School Drama programs at the following schools:
Bloom Elementary (Louisville, KY) Fall 2017 (pdf)
Brandeis Elementary (Louisville, KY) Fall 2017 (pdf)
Goldsmith Elementary (Louisville, KY) Fall 2017 (pdf)
Hawthorne Elementary (Louisville, KY) Fall 2017 (pdf)
Lowe Elementary (Louisville, KY) Fall 2017 (pdf)
St. Albert the Great (Louisville, KY) Fall 2017 (pdf)
Wilder Elementary (Louisville, KY) Fall 2017 (pdf)

QUESTIONS? Contact:
Shannon Woolley Allison, Co-Artistic Director
(502) 638-2559, ext. 700 | shannon@lookingforlilith.org

Pay online: Return to this page after submitting your registration form. Click the Submit Payment button to pay with Square.

Pay by check, cash or money order: Please PRINT YOUR REGISTRATION FORM (using the pdf links for your school) and remit, along with payment, to your school's contact (please see pdf). Make checks payable to Looking For Lilith Theatre.

A limited number of scholarships are available. Please contact Shannon Woolley Allison at (502) 638-2559, ext. 700 or shannon@lookingforlilith.org.

AfterSchool Registration Form
* indicates required field

PARENT/GUARDIAN INFORMATION (Información para los Padres)

(Correo electrónico):

CHILD'S INFORMATION (La información del niño)

EMERGENCY CONTACTS (Información de Contacto de Emergencia)

Contact #1

Contact #2

ELECTRONIC SIGNATURE

In the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant permission for any and all medical attention to be administered to my child/children, in the event of an accidental injury or illness, until such time as I can be contacted. (En caso de una situación de emergencia o no crítica que requiere el tratamiento médico, por este medio concedo a permiso para cualquiera y toda la asistencia médica ser administrado a mi niño/niños, en caso de una herida casual o enfermedad, hasta cuando puedan ponérseme en contacto.)


Photo Consent: I give permission for photographs/video of my child/children to be taken during their participation in this program, to be used in any Looking for Lilith publicity materials, including website. (Doy permiso para las fotos/video de mi niño/s que se deben tomar durante su participación en este programa, para ser utilizado en cualquier Looking for Lilith materiales de publicidad, incluso en el sitio internet.)

Please check this box if you DO NOT wish to receive information on future educational opportunities and information from Looking for Lilith Theatre Company.