Summer Registration 2026

Student Name

First NameLast Name

Student Birth Date

Date

Student Age

Parent/Guardian Name

First NameLast Name

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

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

Please list any health concerns/medications for your child we need to be aware of

Can your child's picture be posted to our Dance Impressions Facebook page?

Please select the summer camp/camps your child will be attending.

Payment Options - please choose below. Class placement will not be held until payment is received. Pre-Registration price ends 4/2/26. All prices increase $5 after this date.

I or we, the parent or guardian, agree to let our child participate in dance activities with knowledge that no insurance coverage or insurance policy is provided to cover participants. I/we acknowledge that by signing this document, I/we may be found by a court of law to have waived any right to maintain a lawsuit against Dance Impressions on the basis of any claim from which I/we have released them herein. I will not hold Dance Impressions and volunteers responsible for any accident to my child or myself, during practice sessions, scheduled events, going to and from such practices or events, playground activities, or out of town events.

Typing my name below indicates I have read and agree to the statement above.

First NameLast Name