Registration
Children's Dance Camp Ages 5-7 June 7-11 9:00 AM-12:00 PM Mon-Fri Theme: Animals Tuition: $125 for the week
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
WAIVER OF LIABILITY (Part I)
  (Show-Hide Details)
I've read the above and agree.
 
WAIVER OF LIABILITY (Part II)
  (Show-Hide Details)
I've read the above and agree.
 
Medical Release
  (Show-Hide Details)
I've read the above and agree.
 
Publicity Release
  (Show-Hide Details)
I've read the above and agree.
 
Payment and Refunds
  (Show-Hide Details)
I've read the above and agree.
 
Late Pick Up Agreement
  (Show-Hide Details)
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: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*