Registration

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Kick off the season with a week full of sunshine and smiles at our Summer Fun Dance Camp! Campers will enjoy dancing, making creative crafts, playing games, and participating in exciting summer-themed activities. Please bring a snack or lunch each day, a water bottle, and wear comfortable clothes ready for dancing and play!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	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

Additional Information:

Other Questions/Comments:

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:*