Registration
4 openings left in this event!
2021 2 Day June Intensive Mini/Jr 10-13yrs NO REFUNDS provided. - VERY LIMITED IN STUDIO SPOTS AVAILABLE - Thank you and see you soon!
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
(Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Has your dancer been exposed to anyone diagnosed with COVID 19 in the past two weeks?*
Has your dancer had a fever within the past 5 days?*
Has your dancer been experiencing any shortness of breath?
Has your dancer had a cough within the last 4 days?
 
Additional Information:
 
COVID 19 Waiver
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I've read the above and agree.
 
Liability Waiver
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I've read the above and agree.
 
Intensive Payment Agreement
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I've read the above and agree.
 
Photo/Video Release
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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:*