Author: Stephanie

stage doors EDUCATION SERIES 2022-2023 REGISTRATION FORM

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SCHOOL/FAMILY TEACHER/CONTACT (ONE NAME ONLY, PLEASE)
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SCHOOL ADDRESS CITY, STATE & ZIP
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SCHOOL PHONE HOME PHONE EMAIL
___________________________ O Public O Private/Parochial O Home School/Family O Childcare Center
GRADE LEVEL(S) ATTENDING
Please indicate the number of vehicles requiring parking at the Weidner Center: ______ Bus ______ Car Would you be interested in having a teaching artist visit your classroom? _____ Yes _____ No ____ Maybe

ACCESSIBILITY NUMBER OF INDIVIDUALS REQUIRING:
______ Wheelchair accessible seating
______ # of wheelchairs ______ # of attendants ______ Easy Access Seating (no stairs) ______ Assistive Listening Device
Sign Language Interpretation
______ Please provide interpreter
______ We will provide interpreter ______ Low/Limited Vision Accommodations
Other (please specify):

Performance	Date	Time (indicate preference)		# Paid Students	Student Price	# Paid Chaperones	Chaperone Price	# Comp* Chaperones	Payment Due	Total Due
EXAMPLE	9/1/22	1 10am	2 12:30pm 21212121212:30pm	50	$7	1	$7	3	8/4/22	$357
Freedom Flight £ Show Only - $7 Show & Neville Museum - $10 ♦ £ Show & Heritage Hill - $10 ♦ £ Show & Railroad Museum - $10 ♦	Mon, Feb. 6 2023	£ 10am	£ 12:30pm		$7		$7		1/9/23
		£ Opt. 1	£ Opt. 2		$10		$10
The Magic School Bus £ Show Only - $7 £ Show & UWGB Day - $10 ♦ Show & Children’s Museum - $10 ♦	Tues, Feb. 21 2023	£ 10am	£ 12:30pm		$7		$7		1/24/23
		£ Opt. 1	£ Opt. 2		$10		$10
It’s Okay To Be Different £ Show Only - $7 £ Show & Children’s Museum -$10 ♦ £ Show & Neville Museum - $10 ♦ £ Show & UWGB Day - $10 ♦	Mon, Feb. 27 2023	£ 10am	£ 12:30pm		$7		$7		1/30/23
		£ Opt. 1	£ Opt. 2		$10		$10
Doktor Kaboom! £ Show Only - $7 £Show & UWGB Day - $10 ♦ Show & Neville Museum - $10 ♦	Tues, Mar. 28 2023	£ 10am	£ 12:30pm		$7		$7		2/28/23
		£ Opt. 1	£ Opt. 2		$10		$10
Adventures of Tortoise and Hare £ Show Only - $7 Show & UWGB Day Show & Children’s Museum £Show & Neville Museum - $10 ♦	Tues, Apr. 11 2023	£ 10am	£ 12:30pm		$7		$7		3/14/23
		£ Opt. 1	£ Opt. 2		$10		$10
The Lightning Thief £ Show Only - $7 £ Show & Children’s Museum - $10 ♦ £ Show & Neville Museum - $10 ♦	Wed, Apr. 12 2023	£ 10am	£ 12:30pm		$7		$7		3/15/23
		£ Opt. 1	£ Opt. 2		$10		$10
She Kills Monsters £ Show Only - $7 £ Show & Neville Museum - $10 ♦	Wed, Apr. 26 2023	£ 10am			$7		$7		3/29/23
		£ Opt. 1			$10		$10

*One complimentary chaperone allowed for every 15 paid students. ♦ Opt. 1 - 10am show followed by Extend the Day activity; Opt. 2 - Extend the Day activity followed by 12:30pm show. Full schedule online. A 25% deposit is required for Museum and UWGB Day reservations.

TOTAL AMOUNT DUE $ ______________
(Four weeks prior unless otherwise noted)

Submit the completed form via EMAIL: weidnereducation@uwgb.edu, FAX: (920) 465-2619 or MAIL: Weidner Center Education, 2420 Nicolet Drive, Green Bay, WI 54311-7001 QUESTIONS? Call (920) 465-5100 or e-mail weidnereducation@uwgb.edu. Show descriptions, policies, and procedures at WeidnerCenter.com