The Coterie Theatre School
The Coterie
2021-2022 Class Registration Form
THE COTERIE
2450 Grand Blvd., Ste. 144
Kansas City, MO  64108
www.thecoterie.org
Register by phone: 816.474.4241

Student Information (One student per form)

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Allergies and/or Special Needs *
 

Parent/Legal Guardian

I authorize the program directors to arrange emergency treatment by qualified personnel for my child *
I authorize the use of my child's image in any future web or print advertisements and understand that my child's name will NOT be used. *

Emergency - First Person Teacher Should Call (Parent? Other?)

Contact Parent/Legal Guardian (listed above) *
Other Emergency Contact (Not required)

Check Class(es) to Register

CC = Coterie Theatre at Crown Center, 2450 Grand Boulevard, Kansas City MO
OP = Miller-Marley School of Dance and Voice, 10448 Mastin Street, Overland Park KS
WINTER - Location:  Crown Center, 2450 Grand Boulevard, Kansas City, MO
SPRING - Location:  Crown Center, 2450 Grand Boulevard, Kansas City, MO
WINTER - Location:  Miller-Marley School of Dance and Voice, 10448 Mastin Street, Overland Park KS
SPRING - Location:  Miller-Marley School of Dance and Voice, 10448 Mastin Street, Overland Park KS
Current Total:
$0.00

Gift Certificate - Complete ONLY if this class is a gift

Discounts & Donation Levels

Discounts can not be combined
Donation Levels - For information about giving level benefits contact Joette Pelster at 816-994-8837

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. *

Payment - Required at time of registration

Current Total:
$0.00
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How Did You Hear About Our 2021-2022 Classes?

Check all that apply *