2026 Summer Camp Registration Form

Summer Camp 2026 Registration Form

Please fill in the form below.
Today's Date*

MonthDayYear
Date
New or Returning Student
Contact and billing information:
Parent #1 Name*

First NameLast Name
Parent #1 Number*
Format: (000) 000-0000.
Parent #2 Name

First NameLast Name
Parent #2 Number
Format: (000) 000-0000.
Primary E-mail*
Email is our #1 form of communication!!
Secondary E-mail
Email is our #1 form of communication, please include if you'd like a second email address to receive notices.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Format: (000) 000-0000.
Students Full Name*

First NameLast Name
Students' Birthday*

MonthDayYear
Date
Allergies or Medical Conditions we should be aware of*
Age*
Years of Dance Training*
Where have you trained?
How did you hear about bellA dance?
Camp Selection*

"You've Got a Friend in Me" (Toy Story Inspired):July 6, 2026-July 10, 2026 9:00am - 12:00pm"Princesses and Pop Stars" (Where Royalty meets K-Pop): July 27, 2026-July 31, 2026 9:00am - 12:00pm"Glow Wild" (Calling all Lisa Frank fans & animal lovers):August 10, 2026 - August 14, 2026 9:00am - 12:00pm
Do you have additional students to register? (note: if registering more than 2 siblings please email belladancedesk.com for help)*

YesNo
Additional Students Full Name*

First NameLast Name
Additional Students' Birthday*

MonthDayYear
Date
Age*
Allergies or Medical Conditions we should be aware of*
Years of Dance Training*
Where have you trained?
Camp Selection*

"You've Got a Friend in Me" (Toy Story Inspired):July 6, 2026-July 10, 2026 9:00am - 12:00pm"Princesses and Pop Stars" (Where Royalty meets K-Pop): July 27, 2026-July 31, 2026 9:00am - 12:00pm"Glow Wild" (calling all Lisa Frank fans & animal lovers):August 10, 2026 - August 14, 2026 9:00am - 12:00pm
Total number of combined camps
Printed Name*
Signature*

Payment 50% of camp price is due at time of registration (Note: by registering for camp, we are removing a space for a student to sign up, thus this is a NON REFUNDABLE deposit. The balance is due on or before the first day of camp).

1 Camp ($210 total/$105 deposit)$105.00

2 Camps ($378 total/$189 deposit)$189.00