SUMMER WORKSHOPS

SUMMER WORKSHOPS - 2025

Thursday Evenings - beginning July 14th
Participant's Name*

Given NameSurname
Participant's Date of Birth*

DayMonthYear
Allergies/Medications
Please list dancer's current allergies, any medication they take regularly or any previous injuries the staff should be aware of.
Parent/Guardian Name*
Primary emergency contact
Parent/Guardian E-mail*
Emergency Contact Phone Number*
Format: (000) 000-0000.
Small Fry/MiniTyke/JuniorSenior
ACRO & FLEXIBILITYTECHNIQUE & SKILL DEVELOPMENT
Registration in ONE 6-week session ($125)Registration in BOTH 6-week sessions ($225)Request to be added to the drop-in list ($30 per class) for ACRO & FLEXIBILITY - you will be contacted if space is availableRequest to be added to the drop-in list ($30 per class) for TECHNIQUE - you will be contacted if space is available
Credit Card (Invoice will be sent via email)Credit Card on File (for returning dancers with card info saved on file)E-Transfer (to jacqueline@studio12dance.com)
I UNDERSTAND
Should be Empty:

SUMMER WORKSHOPS - 2025