Registration
This two-day Hip Hop & Break dance clinic will focus on technique in hip hop, jazz, pop-locking, street dance, and funk. The dancers also work on freestyle movement to promote self-confidence. Dancers will have an opportunity to showcase hip hop techniques, such as handstands, headstands, stalls, and kips, with new steps and age/level appropriate choreography. Beginners: Ages 7 - 10 years Intermediate/Advanced: Ages 11 - up
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
 
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:
 
 
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: