SOLINA Guest Dancer & Free Trial Registration

Child’s Name

SOLINA Friend who invited you *Enter N/A if this is a regular free trial.

Emergency Contact Full Name

Parent/Legal Guardian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Allergies, medical conditions, or accommodations? (Enter ‘None’ if there are no allergies, medical conditions or accommodations)

Child’s Age Group and Classes

What Are You Interested In?

Preferred trial dates (select up to two)

What School Are You Affiliated With?

Preferred Method of Contact

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Student’s Grade Level

Anything else you’d like us to know? Comments or questions.

I certify that I am this child’s parent or legal guardian. By typing my full name below, I agree to the waiver above and provide my electronic signature.

First NameLast Name