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It's time to ring in the New Year! Join Dance 101 and friends in celebrating the beginning of 2022. At the New Year's Dance Party dancers will enjoy learning new dance moves, crafts, games and a full glow stick dance jam. The New Year's Dance Party is open to dancers ages 3-12 from all backgrounds! Parents can enjoy 3 full hours of alone time before the big night. New Year Eve Parent's Night Out Dance Camp is Thursday, Dec 30th from 4-7pm (Students will bring their own sack dinner.)
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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Family Information
First Name:
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Last Name:
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Type
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Father
Grandparent
Guardian
Mother
Parent
Self
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Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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Zip:
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Emergency Contact Info
Students entered below will be added to your family's account
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Student's First Name:
*
Last Name:
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Student Gender:
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Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Special Needs (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #2:
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Student's First Name:
*
Last Name:
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Student Gender:
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Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Special Needs (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #3:
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Student's First Name:
*
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Student Gender:
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Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Special Needs (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Other
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Special Needs (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Other
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Special Needs (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Questions/Options:
Name and age of child(ren) registering.
*
I know that I need to provide a sack dinner for my child(ren).
(checked=yes)
I wish to declare the following physical/mental issues, restrictions, or conditions.
Additional Information:
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Exp Year:
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DE
FL
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HI
IA
ID
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KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
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NE
NH
NJ
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NV
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OH
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OR
PA
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