Broadway By the Bay

ENROLLMENT FORM	YTC Summer 2010
Please fill out this form completely and return to Broadway By the Bay


Student Name:
Birthdate/Age:
Parent/Guardian Name:
Address:
Daytime Phone ( ):
Evening Phone ( ):
Email Address (required):
Camps A & B Camps C & D	Take off $50 if postmarked by May 15, 2010 Take off $25 if postmarked by May 15, 2010

Camp A - Half-Day	July 5 - August 8, 2010 (including performances)	$950.00
Camp A - Full-Day	July 5 - August 8, 2010 (including performances)	$1350.00
Camp B - Half-Day	July 5 - August 8, 2010(including performances)	$950.00
Camp B - Full-Day	July 5 - August 8, 2010(including performances)	$1350.00
Camp C	June 14 - July 2, 2010	$700.00
Camp D	June 14-25, 2010	$450.00
Camp A & B - A La Carte	Weekly Classes TBA	$150.00 x ___

Total Enrollment Amount: $
Tax-Deductible Amount: $
Total Amount: $
Method of Payment: Check Credit Card Visa Master Card American Express Discover
Credit Card Number:	Exp Date:
Signature:	CID#
(Last 3 or 4 digits on back of card/signature box)
Please Check Website for our cancellation Policy

Support our Education & Outreach Program with a tax-deductible contribution to:

Cover the increasing cost of sets, costumes, props, and shipping
Offer scholarships for underserved and low-income children and young people in our community

Broadway By the Bay's Education & Outreach program is committed to providing professional quality musical theatre productions, arts education and training to young people throughout the Bay Area.

Broadway By the Bay/YTC
851 Burlway Road, Suite 300
Burlingame, CA 94010-1720

Erica Wyman, Education & Outreach Director
Erica@bbbay.org - 650.579.5565 ext. 207

650-579-5565 * BOX OFFICE: 851 BURLWAY ROAD, SUITE 300, BURLINGAME CA 94010 * THEATER: 600 NORTH DELAWARE AVE, SAN MATEO, CA 94401