The Coterie

2020 Summer Class Registration Form

THE COTERIE
2450 Grand Blvd., Ste. 144
Kansas City, MO 64108
www.thecoterie.org
Register by phone: 816.474.4241

To register for Coterie classes at PEMBROKE HILL CLICK HERE

To register for Coterie classes in the NORTHLAND CLICK HERE

Student Information (One student per form)

First Name *

Last Name *

Gender *

Birth Date (mm/dd/yyyy) * +

2020-2021 Grade *

2020-2021 School Name or Homeschool *

Allergies and/or Special Needs *

None	Other Other

Student (NOT Parent) Cell Number

Student (NOT Parent) Email Address

My child would like to be in the same class as his/her friend:

Parent/Legal Guardian

First Name *

Last Name *

Relationship to Student *

Email Address *

Enter again to confirm *

Street Address *

City *

State *

Zip Code *

Cell Phone (use dashes XXX-XXX-XXXX)

Landline [Home] Phone (use dashes)

Work Phone (use dashes) 🛈

Place of Employment * 🛈

I authorize the program directors to arrange emergency treatment for my child by qualified personnel. *

Yes

No

I authorize the use of my child's photograph in any future web or print advertisements and understand that my child's full name will NOT be used. *

Yes

No

Emergency - Who is the FIRST Person Teacher Should Call (Parent? Other?)

Contact Parent/Legal Guardian (listed above) *

Yes - Call CELL first	Yes - Call LANDLINE first
Yes - Call WORK first	NO - Call "Other" listed below

Other Emergency Contact (Not Required)

First Name

Last Name

Relation to Student(s)

Phone (use dashes XXX-XXX-XXXX)

Cell

Home Landline

Work

Mark Box for Class/Classes to Register (closed classes are noted)

To register for Coterie classes at PEMBROKE HILL CLICK HERE

To register for Coterie classes in the NORTHLAND CLICK HERE

VR = Virtual Class using Zoom

Times listed are CDT - Central Daylight Time

OP = Miller-Marley at 10448 Mastin Street, Overland Park KS
JUNE classes originally planned in-person in Overland Park will be VIRTUAL - Live & Interactive. See Virtual classes listed above.

OP | This Is Not A Box! l Entering Grades K-2 l July 6-10 | 9:00am-Noon | $140

OP | The Way Of The Force l Entering Grades 3-5 l July 6-10 | 9:00am-Noon | $140

OP | Acting In The Upside Down l Entering Grades 5-7 l July 6-10 | 9:00am-Noon | $140

OP | Make A Scene l Entering Grades 3-5 l July 13-17 | 9:00am-Noon | $140

OP | Funny Bones: Intro To Improv l Entering Grades 5-7 l July 13-17 | 9:00am-Noon | $140

OP | Comedy On Your Feet l Entering Grades 8-12 l July 13-17 | 9:00am-Noon | $140

LS = MCC Longview Campus, 500 S.W. Longview Road, Lee's Summit MO

Longview has extended their campus closure through summer. All Lee's Summit offerings will be VIRTUAL - Live & Interactive. See Virtual classes listed above.

LIB = Liberty Community Center, 1600 S. Withers Road, Liberty MO

Current Total:

$0.00

PEM = Pembroke Hill Lower, 400 W. 51st Street, Kansas City MO

To register for Coterie classes at Pembroke Hill CLICK HERE

PEM | Make A Scene l Entering Grades 3-5 l June 15-19 | 12:30-3:30pm | $175
PEM | Funny Bones: Intro To Improv l Entering Grades 6-8 l June 22-26 | 12:30-3:30pm | $190
PEM | Comedy On Your Feet l Entering Grades 9-12 l June 22-26 | 12:30-3:30pm | $190
PEM | The Addams Family Performance Camp l Entering Grades 9-12 l July 6-10 & 13-17 | 8:30am-3:30pm | $550

PEM | In And Out Of This World! l Entering Grades 1-2 l July 13-17 | 8:30-11:30am | $175

PEM | The Way Of The Force l Entering Grades 3-5 l July 13-17 | 12:30-3:30pm | $175

PEM | Welcome To Musical Theatre l Entering Grades 6-10 l July 20-24 | 8:30-11:30am | $190

PEM | Audition Lab l Entering Grades 6-8 l July 20-24 | 12:30-3:30pm | $190

PEM | Audition Lab l Entering Grades 9-12 l July 20-24 | 12:30-3:30pm | $190

NL = Staley High School, 2800 NE Shoal Creek Parkway, Kansas City MO

To register for Coterie classes in the Northland CLICK HERE (Registration opens TBD)

NL | Funny Bones: Intro To Improv l Entering Grades 5-7 l July 6-10 | 12:30-3:30pm | $140
NL | Comedy On Your Feet l Entering Grades 8-12 l July 6-10 | 12:30-3:30pm | $140
NL | This Is Not A Box! l Entering Grades K-2 l July 13-17 | 9:00am-Noon | $140
NL | Acting In The Upside Down l Entering Grades 5-7 l July 13-17 | 12:30-3:30pm | $140

NL | The Way Of The Force | Entering Grades 3-5 l July 20-24 | 9:00am-Noon | $140
NL | Make A Scene l Entering Grades 3-5 l July 20-24 | 12:30-3:30pm | $140

Summer Camp T-Shirt - $10 each

A t-shirt is NOT required.
-Families who order a Summer 2020 shirt for an IN-PERSON class will receive it at check-in on the first day of class.
-Families who order a Summer 2020 shirt for a VIRTUAL class can pick up the shirt at The Coterie.

Discounts - Coterie classes in Overland Park, Lee's Summit, Liberty, and Northland only

NOTE: The multiple class and sibling discounts are available for Coterie classes in Overland Park, Liberty, and our virtual options. Although Coterie classes are also offered at Pembroke Hill and through the North Kansas City School District, these locations requires registration through their independent websites and can not honor the 10% Coterie discount.

Student in multiple Coterie 2020 Summer classes OR Siblings taking a Coterie Summer 2020 class = 10% Discount

NA

Refund Policy

The Coterie will provide a full refund if given notice two weeks before the first day of the class. Notification must be received two weeks before the first class day for a refund or to request a move to a different class. *

I have read the refund policy and understand that notice must be received two weeks before the first day of class for a refund or to request a move to a different class.

Payment

Current Total:

$0.00

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *

3 Digit Code *

How Did You Hear About 2019 Summer Classes?

Check all that apply to this registration: *

Adult Small	Youth Small (size 6-8)
Adult Medium	Youth Medium (size 10-12)
Adult Large	Youth Large (size 14-16)
Adult XL

www.thecoterie.org	Took a Coterie class before	Miller-Marley flyer/website	Other School flyer (paper or district website)
Coterie class brochure in mail	Coterie email	Pembroke Hill brochure/website	KC Parent magazine/KCParent.com
Insert in Coterie play program	Word of mouth	North Kansas City School District brochure/website	Instagram
Information in Coterie lobby	Facebook	Liberty Community Center brochure/website	Other Other