Registration Request form for Student Dress Rehearsal

February 16, 2023 Mary Irwin Theatre, Rotary Centre for the Arts Note this production references sexual activity and includes some coarse language.

"*" indicates required fields

School / Institution Name*

Club / Class Name*

Instructor / Supervising Teacher Name*

First Last

Email*

Phone*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Student Dress Rehearsal Tickets *

Price: $ 10.00 CAD

Total

Payment information

Payments can be made by credit card, cheque or cash. If you are paying by credit card you can enter your information now. If you are paying by cheque or cash, please select that option below and an invoice with further payment instructions will be emailed to you when your registration is finalized.

Payment Options*

Credit Card

Cheque

Cash

Credit Card*

Cardholder Name

Card Details

Registration Request form for Student Dress Rehearsal

Payment information

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