Summer Program Student Information Form

Summer Programs begin Monday July 8. 9-12PM OR 9-3PM*. 4 days a week or pick your days. *9-3Pm is offered for Ages 5-10 only.

- Please have your dancer dressed in either dance wear or comfortable clothing, Jazz shoes, Ballet shoes or sneakers only. No Jeans, sandals or flip flops. Please keep in mind, the dancers will have crafts every day. Paints, glue and other craft items will be used. Therefore, please plan accordlingly when choosing their clothing for our programs.

- All Dancers must bring their own PEANUT FREE snack and water. Please have their snack and water clearly labled with their name.

Student Information

Student Name*

First NameLast Name

Student Age*

Parent Name*

First NameLast Name

E-mail*

example@example.com

Contact Phone Number*

Emergency Phone Number*

Summer Camp Week(s):*

Day(s) during the week:*

Hours during the week:*

9-12PM9-3PM* Ages 5-10 only

Other Notes

Any Food Allergies?

YesNo

List of Food Allergies

Please let us know if there's any other information you would like to share with us about your child:

Signature of Parent*

By signing above

Summer Camp Interest Form