Register on line here ►

Name:

D.O.B:

Address:

Email:

Phone:

Parents / Guardian:


School:   Year:

Emergency Contact:

Emergency Phone:

Family Doctor:

Doctor Phone:

Medical Conditons:


(your name) I, have read the terms and conditions of enrolment and accept them.  I parent / guardian allow the employed tutor of Mad Cow to seek medical assistance for my dependant in the case of a medical emergency. 

Signed;    Date: 

Venue / Class Choice (tick)
Kincumber (Thursday drama)
Erina (Tuesday - Drama)
Wamberal (Wednesday - Drama)
Mad Cow Studios (Monday and Wednesday) preferred day


I am paying (indicated amount) for the above course/s by:
cheque (Mad Cow Theatre Company)
bankcard  Mastercard  Visa

please call to make arrangements