The Rose Theater

Request a School Show

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Show*

Performance*

Performance (Second Choice)*

School Name*

School Address*

Street Address Address Line 2 City State ZIP Code

School Phone*

Teacher Email*

Teacher Name*

First Last

Grade Level*

Number of Students

Please enter a number from 10 to 800.

Number of Parent Chaperones

Please enter a number from 0 to 800.

Number of Teachers

Please enter a number from 1 to 800.

Is anyone visually impaired, hearing impaired or in need of wheelchair access?*

Yes

Please explain the special needs of your students and how we can best serve them.*

Tax Exempt Number

Number of Buses*

Please enter a number from 0 to 10.

Additional Information

Comments

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