Registration Form: Private Acting, Voice, Guitar & Piano

Hartford Children's Theatre
360 Farmington Avenue
Hartford, CT 06105
Phone: 860-249-7970
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Registration Form: Private Acting, Voice, Guitar & Piano

To register for Hartford Children's Theatre (HCT) classes, please complete the following. If you would like to apply for Financial Aid, please do NOT complete this form. Complete the financial aid form and call our office at 860.249.7970. Thank you.

Bold fields are required.

Student Information

Student's First Name
Student's Last Name
Date of Birth
Male
Female
Grade (as of Sept. '10)
Age
School

Family Information

Home Street Address
City, State, Zip
Email Address
Parent/Guardian 1 Information
First Name
Last Name
Home Phone (Format: ###-###-####)
Cell Phone (Format: ###-###-####)
Place of Employment
Work Phone (Format: ###-###-####)
Parent/Guardian 2 Information
First Name
Last Name
Home Phone (Format: ###-###-####)
Cell Phone (Format: ###-###-####)
Place of Employment
Work Phone (Format: ###-###-####)

Class Information

Class
HCT Staff will contact you for scheduling.

Emergency Medical Information

If Parent/Guardian is unavailable, in case of an emergency please contact
First & Last Name
Phone (Day) (Format: ###-###-####)
Phone (Night) (Format: ###-###-####)
Family Doctor
Name
Phone Number (Format: ###-###-####)
Family Dentist
Name
Phone Number (Format: ###-###-####)
Restrictions or limits on physical activity
Allergies (including food)
Current Medications
Other Current Medical Conditions

Pick-Up List

Please list all people authorized to pick up this student from HCT

Parent Permission

In completing this application I give permission for my child to participate in all program activities, including art projects and outdoor activities.
My child may be photographed and/or videotaped during the course of the program. Such images may be used for archival or promotional purposes by Hartford Children's Theatre.
Absences from class can affect my child's participation in class related performances.
*HCT is NOT responsible for lost, stolen or damaged items. We recommend that personal items remain at home.
I understand and agree.

HCT Policy

Please Note: Registration forms are due 2 weeks before the first class
* Tuition fees must be paid in full 1 week before the first class, or a late fee of $25 is applied.
* Vacation programs require a $100 non-refundable deposit.
* Our tuition fees are not dependent on finalized schedules for the private studios.
*HCT cannot offer refunds on classes that have begun. To be eligible for a class credit, cancellations must be received at least 1 week before classes start. Cancellations received within 1 week of the start of classes cannot be refunded.
* HCT reserves the right to combine or cancel classes that do not have minimum enrollment. Faculty, classes and schedule are subject to change.
* For more info please call 860.249.7970 before submitting registration forms