Registration
Student Showcase by Reflections School of Dance

Saturday, March 22nd, 2025
3:00PM - 4:00PM (performers please arrive by 2:30PM)
Tri-Way Grange 3509 Seattle Hill Road, Bothell, WA 98012

**Registration Fee:
Soloist - $30 ($25 Reflections Team member discount)
Small Groups -$25 each person ($20 Reflections Teams member discount)
Registration Deadline: Notice by Feb. 26 & fees paid by March 11th.
Fees are for one dance. You could register and pay twice if you want to do 2 dances etc.

See Facebook event here for more information: https://www.facebook.com/events/edit/469225829613369
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Relationship to Student*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Please list names of dancers, choreographer, song and time:*
 
Additional Information:
 
 
Other Questions/Comments:
 
Please fill out ONE of the following Payment Methods.
Credit Card Verification:
   
Card Number:  
Name as it appears on card:
Nickname:
Card Expiration Month:   Exp Year:
Address Line 1: Address Line 2:
City: State: Zip:
 
 
eCheck/Bank Draft:
Bank Name:
Bank Routing Number: (9-digit number)
Your Account Name: (Your name on your bank statement)
Your Account Type:   Account Number: