Request Form 2019-2020

* = required

SELECT A PERFORMANCE* (Select all that apply.)

50 States in 60 Minutes – Nov. 18, 2019 – 10am
50 States in 60 Minutes – Nov. 18, 2019 – 12:30pm
Call of the Wild – Nov. 19, 2019 – 10am
Layer the Walls – Nov. 20, 2019 – 10am
Math Maniac – Dec. 4, 2019 – 10am
A Christmas Carol – Dec. 19, 2019 – 10am
A Christmas Carol – Dec. 19, 2019 – 12:30pm
We Shall Overcome – Jan. 21, 2020 – 10am
Pete the Cat – Feb. 6, 2020 – 10am
Pete the Cat – Feb. 6, 2020 – 12:30pm
ArcAttack – Feb. 10, 2020 – 10am
Walk On: The Story of Rosa Parks – Feb. 25, 2020 – 10am
County of Kings – Mar. 6, 2020 – 9:30am
Rosie Revere, Engineer – Mar. 11, 2020 – 10am
Rosie Revere, Engineer – Mar. 11, 2020 – 12:30pm
Hear My Voice: Win the Vote – Mar. 24, 2020 – 10am
Hear My Voice: Win the Vote – Mar. 24, 2020 – 12:30pm
Number the Stars – Mar. 25, 2020 – 10am
Number the Stars – Mar. 25, 2020 – 12:30pm
Macbeth – Mar. 31, 2020 – 9:30am
Llama Llama – Apr. 6, 2020 – 10am
Dr. KaBoom & the Wheel of Science – May 14, 2020 – 10am
Dr. KaBoom & the Wheel of Science – May 14, 2020 – 12:30pm
Miss Nelson Has a Field Day – May 18, 2020 – 10am
Miss Nelson Has a Field Day – May 18, 2020 – 12:30pm

NUMBER OF STUDENT TICKETS*
Enter the amount of student tickets you'd like per show. If ordering multiple performances, please include the show name.

NUMBER OF ADULT TICKETS* (You will receive 1 free for every 10 students)
Enter the amount of adult tickets you'd like per show. If ordering multiple shows, please include the show name. Enter the amount of student tickets you'd like per show. If ordering multiple performances, please include the show name.

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CONTACT INFORMATION

School Address*



Does anyone in your group have special seating needs? (I.E. Wheelchairs, sight, hearing)*
YESNO

PAYMENT INFORMATION
PLEASE NOTE: Payments are due NO LATER than 30 days prior to the performance

My school plans to pay with:*
CHECKCREDIT CARDPURCHASE ORDER followed by check payment

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I acknowledge that my principal and school district have approved this field trip.

I recognize that payment is due NO LATER than 30 days prior to the performance.

I understand The Zeiterion Theatre's cancellation policy and that if payment is not received 30 days prior to the performance date, the seats I have requested may be released for sale to other groups.

I understand that any changes to my reservation must be made in writing 60 days prior to the performance.

I understand that The Z is committed to protecting the privacy and safety of all students and that on occasion The Z may use a photographer to capture the excitement of a Schooltime show for publication including, but not limited to print and electronic publications. I understand that I need to inform the Z's education department at 508-997-5664 or acubellis@zeiterion.org if I am aware of students that may not have their photo taken.

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