Nosara Playhouse Application

Nosara Playhouse & NALA Application

FAMILY INFORMATION
How many Parents/Guardians are responsible for this participant?*
(1) Parent/Guardian*

First NameLast Name
(1) Relationship to Participant*
(1) Cedula or Passport #*
(1) Email*
example@example.com
(1) Phone Number*
(2) Parent/Guardian*

First NameLast Name
(2) Relationship to Participant*
(2) Cedula or Passport #*
(2) Email*
example@example.com
(2) Phone Number*

Nosara Playhouse & NALA Application

GET TO KNOW YOU QUESTIONS
How did you hear about us?*
Why are you interested in Nosara Playhouse and/or NALA?*
Please tell us about where you are coming from and why you chose Nosara?*
How long do you plan to stay in the Nosara area?*
If you could pick one word to define your family, what would it be?*
Our Nosara Playhouse word: Funny!

Nosara Playhouse & NALA Application

ADDITIONAL INFORMATION
Billing Information
Billing Contact*
Parent/Guardian Name
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact In case of Emergency
Contact Name*

First NameLast Name
Contact Email
example@example.com
Contact Phone Number
Is there anything else you would like to add to this application?

Application Fee*

USDNon-refundable fee - $50 per student

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

App Fee Calculation
Should be Empty: