Education Registration - Shea's Performing Arts Center

Class Registration - SING YOUR STORY

Registration is at maximum capacity. Please fill out the registration form below if you wish to be added to the waitlist.

Child Information

Student Full Name(Required)

Age(Required)

Grade at Start of Camp(Required)

T-Shirt Size(Required)

Allergies, Medications, or Special Needs?

Emergency Contact Name(Required)

Emergency Contact Phone(Required)

Parent Information

Full Name (Parent/Guardian)(Required)

Email(Required)

Phone(Required)

Preferred Contact Method(Required)

Pickup Person

Full Name (Approved Pickup Person)

Phone

Are you Interested In Learning More About Financial Assistance(Required)

Yes

Phone

Date of Birth

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please describe any other Shea's programs you have been participated in(Required)

Please describe a brief statement of need describing your financial situation(Required)

What portion of the tuition are you able to commit to paying (in dollars)?(Required)

If there are any special circumstances that we should know about regarding registration, please note that here. (i.e. If you have multiple children in more than one camp, etc.) (Required)

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration

CVC Name on Card

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Campers

Total

Price: $0.00

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Form Mode

This hidden field uses the Form Mode of Active or Waitlist on the Form Setting page to hide and show fields.

Name

This field is for validation purposes and should be left unchanged.

Class Registration - SING YOUR STORY

716-847-0850

716-847-1410