Summer Program Registration Form Student InfoStudent Name* First Last Student Birthdate* MM slash DD slash YYYY mm/dd/yyyyGrade*Select grade for 2026-27 school yearSelect incoming grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeSchool*Student EmailIf different from parent email Parent/Guardian InfoParent/Guardian Name* First Last Parent/Guardian Email* Parent/Guardian Phone*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Morning Intensive Programs (for rising 5th grades and older only)*I’m interested in receiving information about the topics being offered in the morning classes, held 9:30am-Noon from June 15-July 17. Yes No Share with us your top three performing arts experiences*(productions, roles, training or educational programs)T Shirt Size*Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult X-LargeConflict Dates*Please list below potential travel dates, dates of participation in other programs and anything else during the time period of June 15-July 26, 2025 that may impact full participation. IABK Participation*I have participated in the IABK Summer Program or an IABK production in the past. YES NO Teacher InfoLetter of SupportFOR FIRST TIME PARTICIPANTS: Please provide the name and contact information for a classroom teacher who can provide us with insight regarding how your child learns. A brief paragraph can be submitted by the teacher to our program director Allan Lau at allan@imabrightkid.org First Last Teacher phone or email*Statement of Understanding*The IABK Summer Program requires that students be self-motivated and capable of taking direction. There will be moments when students will be asked to practice being good audience members, and may need to sit quietly and observe. If your child is incapable of sitting and participating in this manner, a parent will be asked to attend the program with the student to sit with them during these brief downtimes. Disruptive behavior, or destruction of Paliku Theatre, WCC, Tenney Theatre or IABK property, will not be tolerated and will result in immediate dismissal. I Agree Δ
