​​​REGISTRATION FOR FALL AND SUMMER

Print this page and please mail registration fee payment and this form to:

ZPAC, LLC- a.k.a: Stacy Zawadzki's Performing Arts Center

Southgate Plaza

​954A Union Road, Suite 3

West Seneca NY 14224 US​


NAME:

​PARENT/GUARDIAN:

ADDRESS:

EMAIL ADDRESS:

HOME PHONE:

CELL PHONE:

​WORK PHONE:

EMERGENCY CONTACT NUMBER:

PERSON IN CHARGE OF DROPPING OFF OR PICKING UP:

HEALTH ISSUES:

​AGE AS OF SEPT. :

​PREVIOUS DANCE EXPERIENCE:

​PREVIOUS ACTING EXPERIENCE:

PREVIOUS VOCAL EXPERIENCE:

PREVIOUS THEATRE EXPERIENCE:


PLEASE WRITE WHAT COURSES YOU ARE INTERESTED IN FOR FALL OR SUMMER:​____________________________________________________________________________________________________________________________________


​Reminder: Please send this form and registration fee of $25.00 for first student, $20.00 for the second and $15.00 for the third student etc.

FOR SUMMER: If you already paid registration for the fall of that year, the registration fee is waived for the Summer.

FOR FALL: If new student please pay registration fee for the fall.


​The first day of classes you will be asked to fill out other paperwork.






CONTACT:

ZPAC, LLC-a.k.a. Stacy Zawadzki's Performing Arts Center

Southgate Plaza

954A Union Road, Suite 3,

West Seneca, NY 14224

(716) 608-1010