Registration

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Come wearing your favorite PJ's and be ready for a night full of dancing, games, crafts and fun! Comfy PJ's is the theme, and your dancer will leave with fun memories that are sure to bring sweet dreams! Pizza dinner will be served but you are welcome to bring your own. All participants ages 3-11 must be potty-trained. A great night for the whole family! Cost: $45/1 child; $75/2 children; $95/3 children Signup Deadline: Wednesday @12pm

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info*

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:	Grade Level:
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:

Questions/Options:


Does your child have any allergies? *
Please list an Emergency Contact, in case you are unreachable during the event. *

Additional Information: