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The Coterie
2024 Summer
Class Registration Form
Site: Kansas City Kansas Community College
THE COTERIE
2450 Grand Blvd., Ste. 144
Kansas City, MO 64108
www.thecoterie.org
Register by phone: 816.994.8832
Student Information (One student per form)
*Designates required fields
First Name
*
Last Name
*
Pronouns:
*
she/her
he/him
they/them
they/them
Preferred Name In Class (if different from above)
Birth Date (mm/dd/yyyy)
*
+
2024-2025 Grade
*
Kindergarten in Fall 2024
1st Grade in Fall 2024
2nd Grade in Fall 2024
3rd Grade in Fall 2024
4th Grade in Fall 2024
5th Grade in Fall 2024
6th Grade in Fall 2024
7th Grade in Fall 2024
8th Grade in Fall 2024
9th Grade in Fall 2024
10th Grade in Fall 2024
11th Grade in Fall 2024
12th Grade in Fall 2024
2024-2025 School Name or Homeschool
*
Allergies and/or Special Needs
*
None
Other
Other
My child would like to be in the same class as friend named:
Parent/Legal Guardian
First Name
*
Last Name
*
Relationship to Student
*
Mother
Father
Legal Guardian
Stepmother
Stepfather
Email Address
*
Enter again to confirm
*
Street Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Cell Phone (use dashes XXX-XXX-XXXX)
*
Landline [Home] Phone (use dashes)
Work Phone (use dashes)
🛈
Employer Name/Self Employed/
Stay At Home Parent
*
🛈
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
My student is a resident of Wyandotte County
*
Yes
No
*For non-Wyandotte resesidents all half-day classes are $170 and our full-day class is $550.
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
Second Emergency Contact
First Name
*
Last Name
*
Relation to Student(s)
*
Phone (use dashes XXX-XXX-XXXX)
*
Type
*
Cell
Home Landline
Work
Mark Box for Class/Classes to Register (closed classes are noted)
Registration for classes are closed the Friday before class begins, at 4:00 PM.
If a class is marked FULL or 0 remaining: Cancellations do happen, and openings will show on this page when they occur.
Kansas City Kansas Community College, 7250 State Ave, Kansas City KS (Performing Arts Center)
*all half-day classes are $170 for non-Wyandotte residents; Out Loud: Create Your Own Play is $550 for non-Wyandotte residents
Entering Grades K-2nd: Imaginary Friend Adventures | June 17 - 21 at 9:00am-12:00pm
(1 remaining)
Entering Grades 3rd-5th: Summer Term at Hogwarts | June 17 - 21 at 12:30pm-3:30pm
(3 remaining)
Entering Grades 5th-7th: Audition Lab | June 10 - 14 at 12:30pm-3:30pm
(7 remaining)
Entering Grades 8th-12th: Audition Lab | June 10 - 14 at 12:30pm-3:30pm
(11 remaining)
Entering Grades 6th-12th: Out Loud: Create Your Own Play | June 17-28 at 9:00am-3:30pm; Performs June 28th at 7:00pm & June 29th at 2:00pm
(0 remaining)
Learning Club Registration
(0 remaining)
Summer Camp T-Shirt - $10 each
A t-shirt is NOT required. Shirts will be distributed at check-in on the first day of class
Youth Small (size 6-8)
Adult Large
Youth Medium (size 10-12)
Adult XL
Youth Large (size 14-16)
Adult 2XL
Adult Small
Adult 3XL
Adult Medium
Cancellation Policy
The Coterie requests notification at least two weeks before the first class day if a student must cancel.
*
I have read the cancellation policy and understand that notice is expected at least two weeks before the first day of class if a student must cancel.
Payment Information (only needed if purchasing a class and/or t-shirt)
Name On Card
*
Credit Card #
*
Exp. Date
*
CVV
*
How Did You Hear About 2024 Summer Classes?
Check all that apply to this registration:
*
Took A Coterie Class Before
Information In Coterie Lobby
Instagram
Other School flyer (paper or district website)
www.thecoterie.org
Coterie Class Brochure In Mail
Facebook
KC Parent Magazine/KCParent.com
Coterie email
Kansas City Kansas Community College brochure/website
Word of mouth
KC Studio
Other
Other