GENESIS THEATRE

Student Name:
Current Grade:
Parents Name:
Mailing Address:
Parent Employer:
Phone:	- -
Email Address:
Home Phone:	- -
Cell Phone:	- -
Special Information (i. e. allergies, learning differences, etc: )
Emergency Contact Phone:	- -
Emergency Contact Cell:	- -
Carpool Adult:
Carpool Adult Phone:	- -
Contact Email:
Contact Phone:	- -

Parent Volunteering
Costumes	Props	Sets
Playbill	Box Office	Backstage
Tech/Lights	Concessions
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