Registration

Workshop Schedule: Check-in: 9:30-9:55 <>Introduction:10-10:15 <>Dance with Mackenzie Bell 10:15-11:15am Finished at 11:15am.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
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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:
What is your favorite style of dance?
What made you decide to only take the dance portion of this workshop?
 
Additional Information:
 
Event Commitment:
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I've read the above and agree.
 
Talent & Photo Release
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I've read the above and agree.
 
Indemnity Agreement as Required by my Insurance Company
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ePayment Agreement
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Enter your Full Name: *   
 
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: