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Teacher's Name: _______________________________________________________

School: ______________________________________________________________

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City: ________________County: ______________ State: _______ ZIP:____________

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Home/cell # for weather emergency: ________________________

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Email Address ________________________ Grade Level: ___________

Theatre or Auditorium Title of Show........ Show Date Show Time # of Paid Students & Chaperones # of Free Teachers
           
           
           
           
           

____ If the earlier performance is sold out, please book my group into the later performance.

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