Two River Theater

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INTENSIVES CONTACT FORM

Education Intensives Contact Form

Information we need to register a child for an Intensive course
  • Name of child attending course
  • Date Format: MM slash DD slash YYYY
  • We need to know both the name of the child's Health Insurance Carrier AND the Insurance Coverage account number
  • By entering your full name in this field, you grant permission to representatives of Two River Theater to seek emergency medical care for your child in the event that you cannot be reached or until you are able to be present.
  • Please list the names of the people authorized to pick up your child from Two River Theater's program. Include your name.
    Will you give permission for photos taken of your child to be used in promotional materials, Two River Theater's website, Facebook, Instagram, and/or articles about Two River Theater's education programs.