Coastal Youth Theatre Enrollment

This form must be completed for each student

CYTLogo

Shrek Jr. Waiting List

Student First Name

Student Last NameBirth Date

Address

CityStateZip

Student E-mail

School Attending

Parent/Guardian First Name

Parent/Guardian Last Name

Contact PhoneParent/Guardian E-mail

Are there any allergies, medications, or special limitations you would like your Director to know about?

Stage Experience

Head shot: Please upload a head shot of the student. This is for internal use only. This may be used for name badges, sign-in sheets, etc. A cell phone picture is perfect. This will NOT be used outside of the theatre.

All classes will be held at Main Street Theatre, 331 Main, Conway

CYT Registration