Pierce School Play Registration 7th & 8th Grade Drama / Musical

Please enter information here to register for involvement in the play. If you have previously registered and would like to make a change, please send email to pierceplay@gmail.com.
Please fill in all fields marked with a *
Student's name
First name *   Last name *
Home address *
Phone number(s) *
Email address (preferabably Student's)
*
Demographics
Gender
   Advisor's name:   Transportation to home:
male
female
*		  

*
(for locating this Student)

 

  

*
(e.g., Will the Student walk home or be picked up )

 
Group

Actor
Tech Crew
*

Notes &
Student Paragraph		 (Parent's comments about Student's habits, strengths, learning style, etc. or "Why I'd like to be on the tech crew.")














Parent/Guardian #1
First name: *

  Last name: *
Address(if different from Student's):*


Phone numbers:*


Email address:*
Voluntary tasks (optional):
   

Indicate your hours of availability for voluntary tasks (click checkboxes):
time mon tue wed thu fri
2-3PM
3-4PM
4-5PM
5-6PM














Parent/Guardian #2
First name: *

  Last name: *
Address(if different from Student's):*


Phone numbers:*


Email address:*
Voluntary tasks (optional):
   

Indicate your hours of availability for voluntary tasks (click checkboxes):
time mon tue wed thu fri
2-3PM
3-4PM
4-5PM
5-6PM














Parent/Guardian #3
First name: *

  Last name: *
Address(if different from Student's):*


Phone numbers:*


Email address:*
Voluntary tasks (optional):
   

Indicate your hours of availability for voluntary tasks (click checkboxes):
time mon tue wed thu fri
2-3PM
3-4PM
4-5PM
5-6PM
Emergency contact with phone number *
Other current afterschool activities
time mon tue wed thu fri
2-3PM
3-4PM
4-5PM
5-6PM
 
Please send a check for $95 made out to "Pierce School Play" to:
    Dave Szeto, Treasurer
    82 Davis Avenue
    Brookline, MA   02445
   If you cannot afford the registration fee, scholarships are available.
   (Deborah Dowd 617-277-4259)
Thank you.