CONTACT:
ZPAC, LLC-a.k.a. Stacy Zawadzki's Performing Arts Center
Southgate Plaza
954A Union Road, Suite 3,
West Seneca, NY 14224
(Behind Dollar Tree)
danceactsingstace@gmail.com
(716) 608-1010
REGISTRATION FOR FALL AND/OR SUMMER
Print this page and please mail registration fee of $30.00 payment and this form to:
ZPAC, LLC- a.k.a: Stacy Zawadzki's Performing Arts Center
Southgate Plaza (Behind Dollar Tree)
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:
CREDIT CARD FOR FILE:
HEALTH ISSUES:
MASK: YES OR NO
AGE AS OF SEPT. :
PREVIOUS DANCE EXPERIENCE:
PREVIOUS ACTING EXPERIENCE:
PREVIOUS VOCAL EXPERIENCE:
PREVIOUS THEATRE EXPERIENCE:
PREVIOUS FILM EXPERIENCE:
PREVIOUS MODELING/PAGAENT EXPERIENCE:
PREVIOUS MUSIC VIDEO 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.