Bay to Broadway sign up | Katia and Co

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Katia & Company

Non profit theatre company

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Bay to Broadway Registration
August 10-14 2026
al

Participant's full legal name as on birth certificate*

Preferred name and pronouns, if different

Participants date of birth month/day/year*

Student's phone number*

Parent Info

Parent name*

Parent email*

Phone number 1*

Phone number 2*

Emergency phone number to contact ifparents cannot be reached*

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

503 South Palm Drive Novato, CA

tax ID 82-222-7982

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