Sign Up Form

Print and complete this form and mail with your membership dues to:

Cedar County Theatre
P.O. Box 752
Hartington, NE 68739

Active Membership Dues: $10.00

Junior Membership Dues (under 17 years): $ 5.00

Membership dues will be billed annually in June.

They will be due on July 1.

Last Name: __________________________________ First Name: _______________________

Address:_________________________________________________________________________

Month/Year of Birth (Junior Members Only): _____________________________________________

Email Addresses: __________________________________________________________________

Home Phone: __________________________ Work Phone: __________________________

Date Form Completed: _____________________________________________________________

Comments: ______________________________________________________________________

_______________________________________________________________________________

Areas of Interest:

Usher ____	Publicity ____	Mailing ____	Set Design ____	Singer _________________
Sound ____	Lighting ____	Painting ____	Set Decor ____	Voice Type _____________
Props ____	Makeup ____	Ticket Sales ____	Wardrobe ____	Instrument ______________
Hair _____	Ad Sales ____	Fundraising ____	Director ____	Music Director ____
Other_____	Other________	Other__________	Other _________	Set Construction _________

Cedar County Theatre P.O. Box 752 Hartington, NE 68739

Areas of Interest:

Cedar County Theatre
P.O. Box 752
Hartington, NE 68739