2025 - Spring Convention Registration

2025-SPRING CONVENTION

Sunday March 16
Studio Name
Studio Phone Number
Teacher of Record

First NameLast Name
DMA Member/DMA Affiliated Studio*

YESNO
CONVENTION

March 16- Dance Expressions- 8305 Hedge Lane Terr. Shawnee, KS. List all dancers attending from your studio. Please enter only one dancer per line. Ages are based on the dancers age as of June 1st 2025
6 and Under as of June 1st 2025 - $40 Members / $50 Non-Member
6 and under cost
Ages 7-12 as of June 1st 2025 - $50 Members / $75 Non-Members
Ages 7-12 cost
13 & Over as of June 1st 2025 - $50 Members / $75 Non-Members
13 & Over cost
Teachers/Assistants - FREE Members / $25 Non-Members
Teachers/Assistants cost
Total Cost
Total CC + 4%
Student Release of Liability and Participation - In consideration of being accepted as a participant of the March 2025 Heart of America Chapter 28 Convention I do hereby release Heart of America Chapter 28., the Officers of the Organization, Directors and Assistants, and Dance Expressions -8305 Hedge Ln Terrace, Shawnee, KS 66227 from any and all claims for damages or injuries, which the participant may sustain during any activity connected with this Convention. By signing below, I give my permission as the Teacher / Approved Chaperone for my students to be photographed and or recorded during the March 2025 Convention. It is my understanding that these photographs and recordings will be used solely for Heart of America Chapter 28, at their discretion and in a manner befitting the high standard of the association. Teacher of Record signature below

Clear
Payment Type

CheckCredit/Debit Card
Mail ONE check and a printout of your registration to:

Terzah Wright

1902 Jules St.

St. Joseph, MO 64501

Should be Empty:

2025-SPRING CONVENTION

CONVENTION

Credit Card