Registration

Registration in advance $20. Deadline for advance registration is April 8, 2018 At door registration or after early registration deadline is $25 per child. Your event registration is not complete until payment is received.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone:* Click to Enter an International Number Cell #: Click to Enter an International Number Work #: Click to Enter an International Number
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Does your child have any restrictions that might impact their ability to participate in the Wisconsin Dance and Cheer Clinic?*
Does your child have any allergies?*
Has your child ever participated in any Wisconsin Dance and Cheer class or event previously?*
How did you learn about the WIDC Cheer Clinic?*
Medical Insurance information for my child(ren):*
If my child is injured and would need to be transported to a medical facility my hospital choice is?*
My child's medical providers name and phone number is?*
 
Additional Information:
 
Liability
As the legal parent or guardian, I release and hold harmless Wisconsin Dance and Cheer, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Wisconsin Dance and Cheer, its owners and operators or in route to or from any of said premises.
I've read the above and agree.
 
Medical Emergency
The undersigned gives permission to Wisconsin Dance and Cheer, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health. I request that our doctor/physician be called and that my child be transported to ______________________ hospital. Please include physicians' phone number _______________. Hospital, insurance and provider information has been added to the questionnaire.
I've read the above and agree.
 
Payment
Once you have registered for the cheer clinic, WIDC will respond with details for payment.
Payment options are as follows:
a. You will be able to sign into your existing parent account or newly created account and push payment via ACH with no service fees.
b. You can stop into WIDC during normal business hours to make a cash or check payment. Payment needs to be made on or before Sunday April 8th for advanced registration pricing.
Monday 3pm-9pm, Tuesday 3pm-9pm, Wednesday 3pm-9pm, Thursday 3pm-9pm
Limited hours Sunday April 8th, 2018
c. You can stop into WIDC during normal business hours to make a payment via credit card. Credit card transactions will include service fees. Payment needs to be made on or before Sunday April 8th for advanced registration pricing.
Monday 3pm-9pm, Tuesday 3pm-9pm, Wednesday 3pm-9pm, Thursday 3pm-9pm
Limited hours Sunday April 8th, 2018

I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments: