Registration
TO PAY BY CHECK:
Submit registration online.  ACT will email you an invoice to send in
with your check.
    ACT
    PO Box 62972
    Colorado Springs, CO 80962-2972

TO PAY BY CREDIT CARD:
Submit registration below.  Please indicate that you will be paying by
credit card.  Please do NOT send your credit card number in this
registration!  ACT will send you an e-mail invoice through a secure site.

REGISTRATION IS NOT GUARANTEED UNTIL PAYMENT IS
RECEIVED.  Payment must be RECEIVED within 5 days after
registration!  After 5 days, the spot will be made available
to another student.
Registration
Student Name
Class Title(s)
Total Cost
Age        
Birth Date
Gender
Street Address   
City          
State    
 Zip Code   
Parent's Names  
Home Phone     
Cell Phone
E-mail Address
Medical Release
 In the event of an emergency, I understand that a reasonable effort will be
made to contact me. If I cannot be reached, I hereby authorize an agent of the
Academy of Children’s Theatre (ACT) to act on my behalf to seek emergency
medical treatment for my child, listed above, in the event that such treatment
is deemed necessary by that agent. I authorize the physician selected by said
agent to administer such emergency treatment as said physician deems
necessary (in his/her judgment) under the circumstances. I understand and
agree that I will be responsible for payment of said physician's fee and any
and all other fees or expenses associated with such treatment. I hereby
release the ACT, its agents and employees from any and all claims and
liabilities resulting from participation with ACT-sponsored activities.
I agree with the
terms of the
Medical Release
Date
Publicity Waiver
 Unless informed otherwise in writing, the Academy of Children's Theatre (ACT)
considers photographs taken of students and their work in class and in
performance to be permissible for publication in ACT marketing materials and
in informational publications, including our website.
Payment
Method
 I will be paying by check.
(Send it to the PO Box listed above.)
I would like to pay by credit card.
(ACT will e-mail you an invoice to do so.)
DO NOT include your credit card
numbers in this registration!
Amount of
Payment
 I would like to pay in full at this time.
I would like to pay only the first month
payment at this time.  
Refund Policy
 I have read and understand ACT's
refund policy.  (It is listed on each
camp or class description page.)
Message to ACT
How did you
hear about
ACT?
 There will be a $15 fee for any bounced checks, balance transfers with insufficient funds,
or credit card charge backs.  
NOTE: Payment must be received within 5 days of registration to secure the class
placement.  Registration will be confirmed via e-mail once payment is received by ACT.