DansezDansez Camp Registration | Dansez!Dansez!

Whether you desire to pursue the art of dance as a professional career or as a hobby, we will take you there!

Complete the form online or CampRegistrationForm2016

Camp Registration

SELECT CAMP DATES *
You may enroll for 1 hour, 1/2 day, 1 day, multiple non-consecutive or consecutive days, 1 week, multiple weeks or the entire summer *DateWinter Mini Camp
Enter Single Day Date (s)
SELECT RATE *

STUDENT 1

Last Name *
First Name *
Sex *
FM
Date of Birth (DOB) *
Age *
Allergies/ Condition

STUDENT 2

Last Name
First Name
Sex
FM
Date of Birth (DOB)
Age
Allergies / Condition

MAIN CONTACT

Parent / Guardian Name(s) *
Email *
Home Phone *
Mobile phone
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

EMERGENCY CONTACT

EMERGENCY CONTACT NAME (other than parent or adult participant)
Emergency Phone

AUTHORIZATION & RELEASE *: Please acknowledge by checking each box below

*
Participant or parent/guardian assumes all risks associated with this activity and relieves Dansez Dansez and its representatives of all claims for injuries or loss of any person or property which may result from participating in this program
*
Participant or parent/guardian grants permission for a doctor or emergency personnel to treat participant if needed.
Participant or parent/ guardian consents to Dansez Dansez' use of photographs or videotapes made of the program that include participant for Dansez Dansez promotional purposes
Signature *type in full name
Date

ONLINE PAYMENT COMING SOON. Until then, please MAKE CHECK PAYABLE TO " DANSEZ!DANSEZ! "

Verification

Please enter any two digits with no spaces (Example: 12) *
This box is for spam protection - please leave it blank:

Comments are closed.