2025 WINTER ACADEMY REGISTRATION FORM

Student Name(Required)

First Last

Date of Birth(Required)

Gender

Preferred Pronouns

Predominant Ethnicity or Race

African American

Asian/Pacific Islander

Hispanic

Native American

White

More than one category

Prefer not to say

Address(Required)

Street Address Address Line 2 City State ZIP Code

Student Phone(Required)

Student Email(Required)

Current School(Required)

Current Grade(Required)

Expected Year of High School Graduation(Required)

Parent/Guardian 1

Name(Required)

First Last

Relationship to Student(Required)

Address (If different from student)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Parent/Guardian 1 Email(Required)

Receipt and registration confirmation will be sent to this address.

Employer

Job Position/Title

Parent/Guardian 2

Name

First Last

Relationship to Student

Address (If different from student)

Street Address Address Line 2 City State ZIP Code

Phone

Parent/Guardian #2 Email

Employer

Job Position/Title

Alternative Emergency Contact

In the event of an emergency and a parent/guardian can't be reached.

Name(Required)

First Last

Relationship to student(Required)

Phone(Required)

Parent/Guardian signature required for students 17 and under; Participant signature for ages 18 and up.

Media Release Statement: My signature below grants consent to Trollwood for the use of media images (including, but not limited to photographs, film, digital images, and video), interviews, and survey responses involving my child/myself for publicity and marketing purposes for the organization. These may appear in, but are not limited to publications, presentations, advertisements, websites, or media showings of Trollwood programs and performances.

Signature(Required)

Date

Class Registration

Class details are available at www.trollwood.org/winter-academy

Trollwood Winter Academy Registration

Classes

High School (Grades 8-12) Musical Theatre Audition Prep

Middle School (Grades 5-7) Musical Theatre Audition Prep

Black Friday Discount

$0.00

Total

Credit Card

Card Details

Cardholder Name

Phone

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