ENROLMENT form

Student Name *

First Name

Last Name

Preferred Name

Do you have a preferred name you like to be called?

First Name

Last Name

Parent/Caregiver or Account Holder Name *

(Account holder if 18+)

First Name

Last Name

Parent/Caregiver #2

First Name

Last Name

Parent/Account Holder Mobile *

Best phone contact

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name

If different to parent/account holder contact

First Name

Last Name

Emergency Contact Number

If different to account holder

(###)

###

####

Terms, Conditions & Permissions *

I have read and accept the Terms & Conditions of Enrolment

I give permission for Upstage to email information regarding classes and productions.

I give permission for Upstage to use photographs of my child (if under 18) for promotional and archival purposes.