PYS Theatre Enrolment Form

(No payment required)

Child's First Name*
Child's Surname*
Child's Date of Birth*	/ /
Child's T-Shirt Size* (please indicate child/ladies/mens)
Parent/Guardian 1 Full name*
Parent/Guardian 2 Full name
Postal Address*
Postcode*
Home Phone*
Mobile*
Email Address*
Please not any medical, developmental or behavioural issues regarding your child that we should be aware of:

I agree to allow my child's photo to be published on the Perry's Young Stars website and promotional materials. (No names will be used)*
Yes No
Class Location*
Class Time*
Payment Options*
* Mandatory Fields