Program Applying For: *

Crow Comedy Camp (ages 7-12)

Comedy School For Kids (ages 8 - 12)

Teen Stand-Up Class (ages 13 - 17)

Stand-Up 101 (adults)

Stand-Up 201 (adults)

Name *

First Name

Last Name

Participant's Name (if different)

First Name

Last Name

Race: Please check all that apply *

African American or Black

Asian / Pacific Islander

Caucasian

Hispanic or Latino

Middle Eastern

Native American or Alaskan Native

Decline to State

Other

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date

MM

DD

YYYY