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Katia & Company

Non profit theatre company

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Cruel Summer

Participant Name*

Preferred name and pronouns, if different

Grade in fall 2026*

Sibling or friend participating:

Parent info

Parent name*

Parent email*

Phone number 1*

Phone numer 2*

Phone number to contact if parents cannot be reached*

I have read and agree to the terms of the waiver.

Does your child have any allergies, medical conditions, or developmental concerns we should know about?

Anything else you'd like us to know?

Per participant

$595

503 South Palm Drive Novato, CA

tax ID 82-222-7982

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