The Coterie Theatre School
The Coterie
2021 Fall Class Registration Form
2450 Grand Blvd., Ste. 144
Kansas City, MO  64108
Register by phone: 816.474.4241

Student Information (One student per form)

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
NL = Northland - COMING SOON!
Coterie classes are by the student's current grade and not by age.  If a child is 5, but not currently participating in a 2021-2022 kindergarten class at school, the Early Childhood classes are appropriate.  If a child is in kindergarten, they should enroll in the K-1st grade class.  
PARENTS:  A student must CURRENTLY be in the grade listed, regardless of age, in order to register for the class.
Location:  Crown Center, 2450 Grand Boulevard, Kansas City, MO
Location:  Miller-Marley School of Dance and Voice, 10448 Mastin Street, Overland Park KS
Current Total:

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:

How Did You Hear About Our 2021-2022 Classes?

Check all that apply *