Dear Parent,


We are delighted your child will be joining us for Piper Theatre's Summer Workshops. Please complete the form at right to register.

The season begins Tuesday, July 2 and runs through July 28, with final performances July 25-28.  The Starlings program runs for two-week sessions, July 2-13 and July 16-27, with performances at the end of each session.  Piper will be closed Wednesday, July 4.

The workshops will take place at the Old Stone House of Brooklyn, 5th Avenue, between 3rd and 4th Streets, and in the classrooms of MS 51, across the street.

After submitting your registration you will have the option to make your payment online or by mail. Checks should be made payable to Piper Theatre Productions. Please include your child's name and workshop in the memo field and mail to Piper Theatre Workshop, PO Box 150613, Brooklyn, NY 11215.

Space is limited so please register early to guarantee a spot for your child. Pay in full by January 31 and receive a $70 discount. (Starlings not included.) Your non-refundable deposit of $350 is due at time of registration with the balance to be paid by June 15, 2012.

The period for applying for financial assistance ended March 7, 2012.

Questions? Email john@pipertheatre.org or call Kim Maier (718) 768-3195.


Registration for Garden Explorers Session Two

 
You are registering for Garden Explorers, Session w
Student Contact Information
Student First Name
Student Last Name
Street Address
Apt
City
State
Zip
Student Home Phone
Student Cell Phone
Student School
Student Grade, Fall 2011
Parent(s) Contact Information
Parent First Name
Parent Last Name
Street Address
Apt
City
State
Zip
Parent Cell Phone
Parent Email Address
Parent 2 First Name
Parent 2 Last Name
Parent 2 Home Phone
Parent 2 Cell Phone
Parent 2 Email Address
Additional Contacts and Information
Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone. Use numbers in the format xxxxxxxxxx (e.g 2125555555)
Emergency Contact Name 2
Emergency Contact Relationship 2
Emergency Contact Cell Phone 2
My child has the following activity or medical restrictions:
Family Physician Name
Family Physician Phone. Use numbers in the format xxxxxxxxxx (e.g 2125555555)
My child has permission to attend any and all program field trips.
My child has permission to leave independently after the program each day.
Release and Waiver of Liability: While participating in activities at Piper, each student is assumed to be voluntarily performing activities for which he/she assumes all risk, consequences, and potential liability. My child agrees to adhere to the Piper Code of Behavior. The undersigned hereby releases and hold harmless Piper Theatre Productions and the Old Stone House and its agent or agents from any and all claims arising or resulting directly or indirectly from participation in the Piper Theatre at OSH. I authorize Piper Theatre Productions to take necessary action in case of emergency if I am unable to be reached. In addition, I authorize Piper Theatre Productions and the Old Stone House to use photographs or recorded video in which my child appears in promotional literature, ads, displays or any format representing the program.
Today's Method of Payment. After submitting your registration, your browser will direct you to our online payment processor. If you will be paying by check, please indicate so here and look for an email confirmation with more details.