Registration

Registration in advance $20. Deadline for advance registration is March 1, 2022 At door registration or after early registration deadline is $25 per child. Your event registration is not complete until payment is received. Payment must be paid online by credit card, ACH (check payment), or dropped off to WIDC on or before March 1, 2022 to receive the early registration discount.
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
 
Questions/Options:
Please indicate your childs t-shirt size (Youth extra small (YXS) , youth small (YS), youth medium (YM), Youth Large (YL), Adult Small (AS), Adult medium (AM), Adult large (AL)*
Has your child ever participated in any Wisconsin Dance and Cheer class or event previously?*
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?*
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:
 
COVID
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I've read the above and agree.
 
Liability
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I've read the above and agree.
 
Medical Emergency
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I've read the above and agree.
 
Payment
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I've read the above and agree.
 
Enter your Full Name: *   
 
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: