Request Form

* = required

SELECT A PERFORMANCE* (Select all that apply.)

Rainbow Fish – OCT. 15, 2018 at 10am – $9
The Crucible – NOV. 5, 2018 at 9:30am – $8
Charlotte's Web – DEC. 5, 2018 at 10am –$8
Charlotte's Web – DEC. 5, 2018 at 12:30pm –$8
A Christmas Carol – DEC. 14, 2018 at 10am – $8
A Christmas Carol – DEC. 14, 2018 at 12:30pm – $8
The Very Hungry Caterpillar – JAN. 7, 2019 at 10am – $9
Freedom Train – JAN. 18, 2019 at 10am – $8
Freedom Train – JAN. 18, 2019 at 12:30pm – $8
iLuminate – FEB. 7, 2019 at 10am – $10
Danny Carmo’s Mathematical Mysteries – FEB. 13, 2019 at 10am – $9
Danny Carmo’s Mathematical Mysteries – FEB. 13, 2019 at 12:30pm – $9
Winston Churchill: The Blitz – MAR. 1, 2019 at 9:30am – $9
Rosie Revere, Engineer – MAR. 14, 2019 at 10am – $8
Rosie Revere, Engineer – MAR. 14, 2019 at 12:30pm – $8
Animal Farm – MAR. 21, 2019 at 9:30am – $8
Number the Stars – APR. 2, 2019 at 10am – $8
Number the Stars – APR. 2, 2019 at 12:30pm – $8
Ballet Hispanico – APR. 12, 2019 at 10am –$10
In to America – APR. 29, 2019 at 9:30am – $9
Magic Treehouse – MAY 28, 2019 at 10am – $8
Magic Treehouse – MAY 28, 2019 at 12:30pm – $8
The Magic School Bus – JUN. 5, 2019 at 10am – $8
The Magic School Bus – JUN. 5, 2019 at 12:30pm – $8

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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