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Will Jessup Contemporary Dance Workshop June 14th 12:00 until 2:00 Ages 11 and up. $25 cash day of workshop Open to all dancers in our area, not just Solstice Dancers .

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Family Information

	First Name:*	Last Name: *
	Type
	Home Phone:	Cell #: Work #:
	Email:	(Emails are kept confidential)

	Address: *
	City: *	State/Prov: * Postal Code: *
	Emergency Contact Info (Not Contact #1 or #2)*

Students entered below will be added to your family's account

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	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)
	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):

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