Are you a new or returning student?
If you are new, how did you hear about us? If you are returning, what are any specific goals, suggestions, or things you are looking forward to this coming year?
Twirler's First Name
Twirler's Last Name
Twirler's Email Address (If they have one. If not, leave blank! )
Twirler's Cell Phone Number (If they have one. If not, leave blank!)
Twirler's Age as of September 1, 2020
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Guardian's First Name
Guardian's Last Name
Guardian's Email Address
Guardian's Cell Phone Number
Class / Team Registration
What would you like your involvement to be? (You may select all that apply)
Weekly Private Lessons ($25 for 1/2 hour; $40 for 1 hour)
Group Lessons (held Monday or Thursday with Miss Pam) (45 minutes per week, $60 a month)
Mini's Group Lessons (ages 0-5 held Monday with Miss Pam) (30 minutes per week, $50 a month)
Nationals Competitive Team (Sept - Dec 2020 - $95 - 1 in person choreography weekend per month, 1 virtual choreography weekend per month, 2 x 1 hour clinic weekends, 4 x 45 min dance classes) ; January 2021 - $110)
Intro Competitive Team ($40 per month will follow simplified version of Nationals Comp Team Schedule)
Would you like to schedule a regular private lesson?
If you selected yes, who would you like to schedule with? Please note all private lessons are to be paid in cash at time of lesson or before.
PJ - https://www.signupgenius.com/go/4090f45afa62ca3fd0-2020
Jon - https://www.signupgenius.com/go/4090f45afa62ca3fd0-2020
Medical Insurance Information
Medical Insurance Provider
Medical Insurance Policy Number / Group Number
Name of Policy Holder
Emergency Contact's Phone Number (xxx-xxx-xxxx)
Emergency Contact's Relationship to Twirler
Please list any known allergies.
I know of no reason(s), other than indicated on this form, why my child should not participate in twirling activities.
I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending The ShowTwirlers and that such exposure or infection may result in personal injury, illness, permanent disability, and death. By signing this agreement, I agree that my child and any accompanying persons will not enter The ShowTwirlers studio or a practice of any nature if we exhibit any of the following new or worsening signs or symptoms of possible COVID-19: A temperature greater than 100.4 degrees Fahrenheit, cough, shortness of breath or difficulty breathing, other respiratory symptoms, or at least two of the following symptoms: chills, repeated shaking with chills, muscle pain, sore throat, fatigue, headache, sore throat, congestion or runny nose, nausea or vomiting, diarrhea, or new loss of taste or smell. I also agree that, neither my child(ren) nor any accompanying adult will enter if we have had known close contact with a person who is lab-confirmed to have COVID-19. The ShowTwirlers will maintain a strict cleaning and safety protocol. By signing this, athletes and their family members agree to follow guidelines while on premises.
I give permission to The ShowTwirlers to use photos taken of my child participating in twirling activities for the promotion of our studio and baton twirling.
I give my consent to the administration of emergency medical treatment by any licensed physician or dentist and to transport the child to any reasonably accessible medical / hospital facility. Initial below.
Other Information About Twirler
Current Baton Size
I have no idea.
Current Shoe Size
Would you like to order any of the following?
ShowTwirler Warm Up Jacket
Any additional comments, scheduling concerns, or things you would like Miss Pam, PJ, or Jon to consider? If you were with us last year, what is some feedback for us so we can continue to improve this coming year?
Booster Club Support
Please pick 3 areas that you (the parent or guardian) would be willing to help with!
Nationals Good Luck Party
End of Year Picnic
ShowTwirler Gear Coordination / Ordering
Historian (photographer at events!)
Alumni Group Coordination
Twirl Fest Competition Prep
Little Buddy Program
PA State Teams Competition Prep
Exhibition Prep (Comp Team Only)
Camp Week Mom (Comp Team Only)
Competition Arrangements (Comp Team only)
Sponsorships (Comp Team Only)
Exhibition Raffle Baskets (Comp Team Only)
( X )
Credit Card Number
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