Student Matinee Registration Request

Music From the Sole - Thursday, March 11th at 11am to 12pm Target grades: 3-12

$2.50 Facility Fee per person

Registration requests are taken on a first come first served basis and admission is not guaranteed. You will be contacted within a week of your request. If you have not been contacted within a week, reach out to the Community Engagement Manager Willy Palomo at w.palomo@utah.edu

Your Information

First Name *

Last Name *

School Name *

School District *

Type of school *

List each classroom teacher including yourself in the space below. *

School Address *

City *

State *

Zip *

Primary Phone Number *

Alternate Phone Number *

Email Address - ALL CORRESPONDENCE INCLUDING LINK TO PAY WILL BE SENT TO THIS ADDRESS *

Number of classes *

Number of students. *

Number of adults you would like to attend the performance? *

Grade level of students Please mark all that apply. *Indicates Target Grade *

We will be using the following transportation - check all that apply (if this changes you need to notify us prior to the event): *

We need the following accommodations - For other, please state the reason for accommodation. For any accommodation, please elaborate in the comment section below if needed. *

Photography and videotaping of students is occasionally done for reporting, grant and publicity purposes. I understand that students' images may be used for these purposes. I agree that if there is a problem with this, I will explain the exceptions that need to be accomodated in the comment section below. *

Yes

Fee and Event Confirmation Information

There is a $2.50 facility fee for this event. If your registration is accepted, you will be notified by email. All correspondance, including payment information and a payment deadline will be done via email. You will be asked to confirm your attendance via email. Failure to confirm and or pay by the deadline without prior arrangement can result in the cancellation of your reservation. *

I have read and understood.

We have limited ability to help with fee reductions but we will consider all applications regardless of whether your school is Title I or not. Please check the appropriate box below. Please articulate reason for request in the comment box below - requests will be automatically denied if no reason submitted. To receive a reduction we must know your free/reduced lunch rate for the school so please fill in the appropriate field. *

I do not need financial assistance.

I would like to request a facility fee reduction and have listed reasons and Free/Reduced lunch rate below.

Title I - this is for data collection only and not a determining factor in admittance to event. *

Please indicate Free/Reduced Lunch Rate for your school. If you are requesting a reduction, this field must be filled out.

If requesting a fee reduction, please list reasons below. Please include information in addition to Title I status.

Below is information that will assist us in data collection for our reporting for grant and fundraising purposes. Please assist us by answering the following questions.

Not including this matinee, how many times have you brought students to UtahPresents shows in the past? *

Are you combining your trip to Kingsbury Hall with another activity? Please mark below all that apply. *

Additional comments or questions.

Thank you for your interest in UtahPresents Student Matinees. Your order will be processed on the next business day. Please note that submitting a registration request does not guarantee admission. You will be contacted within 48 hours regarding the status of your request. If you do not hear from us within 48 hours you need to contact us immediately since this means your registration request did not go through and we have no record of your request.

For Office Use Only