DANCE CAMP

Camper Name

LIST OF ALL WHO CAN PICK THE CHILD UP

DANCE CAMP

MEMBER RATE ($60.00)
NON-MEMBER RATE ($75.00)

Date of Birth

List of any allergies or medical problems we need to be aware of. Please list plan of procedure.

MEMBER NUMBER IF NOT A MEMBER JUST TYPE N/A

Gender

Male
Female

A signed waiver by this registrant will be required before you can download your QR code. A link to obtain waivers for all registrants will be shown on the confirmation page.

You child cannot attend until all the blank lines are filled in.

Parent/Guardian Name

Phone Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Address

MEMBER ID

Emergency Contact

Emergency Contact Number

Yes, it's okay to send me text messages including confirmations, changes, and updates. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Give the gift of registration with a voucher for a friend

Amount$

Recipient Email

We will send an email with the voucher code.

Add Voucher

Convenience Fee

$0.00

Running Total

$0.00

coupon Code

Total

$0.00

Event Registration Software by RegFox

PARENT / GUARDIAN INFORMATION

Give the gift of registration with a voucher for a friend