ABT-DSI08 Congrats Packet - Dance - Wayne State University

CHECKLISTReturn this form along with the following completed items and payment to the Detroit Opera House byJUNE 2 nd , 2008.Items to be paid:Item Total____ 1. For resident ABT students only (See Room and Board Registration Form)Room & board $1650; Activity & Transportation fee $100; Total $1750 $(Please include final performance ticket orders with your final payment)____ 2. For non-residential ABT students only (See Commuter Students & Registration Form)Commuter Fee, Lunch Plan and optional Weekend tripsCommuter Fee $200; Lunch Plan $110 (to be paid directly to AVI Food Systems);Weekend Trips (optional), $15 each, 3 total $(Please include final performance ticket orders with your final payment)Use the PAYMENT FORM to indicate method of paymentOther forms to be completed and returned:____ Arrival/Departure Form____ Student Insurance Information/Medical History(Include a copy of front and back of insurance card.)____ Medical Treatment Consent Form (notarized)____ Indemnification and Release (notarized)____ Physical Examination Form (with physician’s signature)____ Conduct Agreement Form (with student’s and both parents’ signatures)____ Commuter Student Form (if applicable)Ticket Order FormUse the enclosed PAYMENT FORM to indicate whether you will be paying by check or credit card.If paying by check, make payable to: Michigan Opera Theatre and mail with all completed forms to:Michigan Opera TheatreAmanda Woodcox, Administrative Assistant1526 BroadwayDetroit, MI 48226Check List 4/22/200813