Enrollment Information

 
 
 
 
 
 
PIN POINTS THEATRE'S
MIND, BODY, and SERVICE YOUTH PROGRAM

REGISTRATION FORM

Name______________________________________________________________________

Address____________________________________________________________________

City/State/Zip Code___________________________________________________________

Telephone Number_________________________Email_____________________________

Date of Birth (Optional)___________________Age (Optional)________________________

Emergency Contact_____________________________Telephone_____________________

Health Problems____________________________________________________________

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Special Skills_________________________________________________________________

Interests____________________________________________________________________

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Signature__________________________________________Date____________________

 
 For enrollment information, call: 202-582-0002
 Please email this form.