Movin N Groovin Dance

1
Name of Guest Attending* This field is required.Dance is open to any adult with an Intellectual Disability
First Name
Last Name
2
Tuesday, July 28th, 2026

6pm-8pm

*Doors Open At 5:45pm*

Theme:

We Are The Firecrackers Of The Floor

Attire:

Wear your Red,White, and Blue!!

Snack:

Snow Cones

Concession Available:

$1 Items

Location:

Lakeside Venues
400 Old Rt 21 Rd
McClellandtown, PA 15458
3
Contact Information* This field is required.
Please enter a valid phone number.
4
Chaperone's Name* This field is required.Each guest is required to have a chaperone with them during the entire event
First Name
Last Name
5
Contact Information for Chaperone* This field is required.
Please enter a valid phone number.
6
Any special information we should be aware of?Allergies, special accommodations, etc
Huge
Large
Normal
Small
Ok
Ok
7
Is registered individual celebrating their birthday this month?* This field is required.We will be announcing all monthly birthdays and singing happy birthday
YESNO
8
For faster registration please use the following link to register for the dance:

https://form.jotform.com/221385003438046

$3.00 for every client due at the door.

$3.00 for any chaperone who would like to purchase a snack ticket.

Additional donations are accepted at the door to help offset the costs of each event. ALL proceeds received will be used for Movin N Groovin dance purposes.
9
For faster registration please use the following link to register for the dance:

https://form.jotform.com/221385003438046

$3.00 for every client due at the door.

$3.00 for any chaperone who would like to purchase a snack ticket.

Additional donations are accepted at the door to help offset the costs of each event. ALL proceeds received will be used for Movin N Groovin dance purposes.
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