Calling all Lost Boys and Girls! Grab your pixie dust and think happy thoughts as we imagine and dance our way through an amazing Neverland adventure! The camp will include: Crafts, Snacks, fun activities and music that your child will be singing and dancing to for days.
Start Date/Time: End Date/Time:
Fee per Student: Room:
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Family Information
First Name:* Last Name: *
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
Additional Information:
Liability Release
In consideration of the benefits of instruction provided by Dancer-Strong for my child, I, intending to be legally bound, do hereby waive claim and release Dancer-Strong, Directors, Faculty, instructors, personnel, and Facility named above for claim or liability for any injury, or accident occurring or arising from the instructional program or incidental sponsored activities.
I've read the above and agree.
Photo Release
The undersigned grants Dancer-Strong his/her permission and authority to use his or her son’s or daughter’s name, voice, picture, and likeness in connection with any and all publications, media broadcasts, promotional photographs, promotional posters, commercial products, including but not limited to pictures, advertising, Web site and any other commercial items.
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*