Camp25 Dance

Camper's Name

First NameLast Name

Camper's Age

Gender

What school does your child attend?

Does your child have a sibling participating in the Dance Program? If so, please provide the siblings name and age.

How many years organized dance experience does your child have?

Camper's T Shirt Size

Has your child participated in a prior Camp25 event?

Grade

How tall is your child?

On a scale from 1 to 10, 10 being the highest what would you rate your child's athletic ability?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number (CAMP25 will use this phone number to contact you concerning all logistics)

Format: (000) 000-0000.

E-mail

example@example.com

Emergency Contact's Name

Relationship (example - mom, dad, uncle, aunt, etc...)

Phone Number

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

Informed Consent and Acknowledgement By signing this form, I understand that I have registered my child to participate in Camp25 activities. Participation is completely voluntary, and I understand that I assume all risk and accept responsibility for all injuries or permanent loss that may be incurred while participating. I hereby attest and verify that I have been advised of the potential risks. I am granting permission for her/him/they to participate despite possible risks, to include all risks associated with a pandemic or COVID-19. I further release and indemnify Camp25, Franklin Department of Park and Recreation, Franklin City Public Schools, Southampton County Public Schools, Courtland Community Center, all volunteers, agents, or any other related entities of all responsibilities to include any expenses regarding care should my child get injured. I understand and agree that Camp25 is not responsible for property that is lost, stolen, or damaged. I further understand that participation in Camp25 activities may result in a camper being interviewed, photographed, or video-recorded which would result in my child’s photo being posted on Camp25’s website, social media, and other media websites for promotion of the organization.

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Camp25

$85.00 Dance Registration Fee + $8.00 PayPal Processing Fee

$93.00

Total

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Camp25 Dance

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