Education Registration Form

Programs and Payment

Please check which programs you are registering for:
Payment options:

If you choose to pay online, the registration confirmation page and email will include a link to pay online, including special bundle pricing and extra hours registration for all three programs.

If you are requesting financial aid, a representative will reach out via email to discuss options and bill any payments separately.

Please note that your registration is not confirmed until payment is received. All purchases are non-refundable.

Student Information

Student Name: (*)
Date of Birth: (*)
Gender/Pronouns (if desired): (*)
Grade and School: (*)

Guardian Information

Parent/Guardian Name: (*)
Email Address: (*)
Phone Number: (*)
Street Address: (*)
City: (*)
State: (*)
ZIP Code: (*)

Emergency Contact

Emergency Contact: (*)
Relationship To Student: (*)
Emergency Email: (*)
Emergency Phone: (*)

Other Information

Has your child ever participated in a Reagle Music Theatre/Youth Theatre program before? (*)
Please give a brief overview of your child's theatre/music/dance experience. (Beginners always welcome!) (*)
Does your child have any allergies or medical/behavioral conditions we should know about in order to best support them in this program? (*)
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