Reservation Request form for Student Matinee Series showtimes What show are you reserving tickets for?(Required)OnceLady Day at Emerson's Bar and GrillTeacher Name(Required) Discipline/Class(Required) School Name(Required) Grade Level(s) Attending(Required) School Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School County(Required) Email(Required) School Phone #(Required)School Fax #Mobile Phone #(Required)To be used for emergencies and/or day of show information.Are you a Title 1 School? Yes, Title 1 No Would you like to attend the post-show talk-back conversation with the cast? Yes No Unsure Choice of DatesWe will make every effort to seat your group on the requested date, but if we can’t, we will aim for one of your alternate dates. We cannot guarantee that all groups will be seated on their requested dates. Selecting only one date will reduce your likelihood of a reservation.Third ChoiceSeptember 14 at 10amSeptember 19 at 10amSeptember 21 at 10amFirst Choice(Required)September 17 - 10amSeptember 19 - 10amSecond ChoiceSeptember 17 - 10amSeptember 19 - 10amThird ChoiceOctober 31 at 10amNovember 9 at 10amFirst Choice(Required)October 15October 17October 22October 24Second Choice(Required)October 15October 17October 22October 24Third ChoiceOctober 15October 17October 22October 24Second ChoiceFebruary 20 at 10amFebruary 22 at 10amFebruary 27 at 10amFebruary 28 at 10amFebruary 29 at 10amThird ChoiceFebruary 20 at 10amFebruary 22 at 10amFebruary 27 at 10amFebruary 28 at 10amFebruary 29 at 10amFirst Choice(Required)May 7 at 10amMay 9 at 10amSecond ChoiceMay 7 at 10amMay 9 at 10amThird ChoiceMay 7 at 10amMay 9 at 10amAccessibility Requests(i.e. Accessible seating, ASL Interpreter, Braille program or other). Ticket Quantity + CostOne chaperone is free with every 10 tickets for groups with fewer than 100 students (10 student tickets + 1 free chaperone) One chaperone free with every 20 tickets for groups with over 100 students. (20 student tickets + 1 free chaperone)# of student tickets Quantity Price: $10.00 Quantity # of free chaperone tickets Quantity Price: $0.00 Quantity # of addl. chaperones Quantity Price: $10.00 Quantity Total We will contact you if all of your selected performances are sold out.Any questions or comments? Thank you! When you submit this form, a copy of your responses will be sent to your email.Further questions? Contact Melinda McCrary, Director of Education and Community Programs at mccrarym@kcrep.org or 816-235-5708.
