Princess & One-Day Summer Camp Registration

Downtown Dance: Princess & One-Day Summer Dance Camp Registration Form

Please fill in the form below.
Dancer's Name*

First NameLast Name
How did you hear about us?*
Camp T-Shirt Size*
Dancer's Age at camp*
Birth Date*
Sex*

FemaleMale
Guardian's Full Name*
E-mail*
Secondary Email*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Primary Phone Number*

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
Does the dancer have any medical problems we should be aware of?*
Wk of June 6, M-F

Princess Ballet (ages 3-4), 4:30-5:15pmPrincess Ballet/Tap (ages 4-5), 5:30-6:15pmPrincess Ballet/Tap (ages 5-7), 6:30-7:15pm
Princess Camps Include
-Five classes, princess cd, & t-shirt
-Wear your princess costume over leotard/tights on Friday. Parents invited to watch the second half of Friday’s class.
Princess Camp Fee: $75
One-Day Camps

Beginner Hip Hop (ages 8-12), M June 27, 8:30am-12pmJazz (ages 8-12), T June 28, 8:30am-12pm *must have dance exp.Ballet/Lyrical (ages 8-13), W June 29, 8:30am-12pm*must have ballet or jazz exp.
One-Day Camps include-
-3.5 hours, headband & t-shirt, snack provided
One style of dance/One Day Camp Fee: $75
If you wanted to join the Wizard of Oz summer camp, return to www.downtowndance.org for the separate Oz registration form.
Emergency contact/relation*
Emergency Contact Phone*

Area CodePhone Number
I hereby release Downtown Dance, employees/independent contractors from all liability for personal injury, illness, or property damage occurring on or off the studio’s premises. I authorize Downtown Dance to seek medical treatment at the nearest medical facility and they may call paramedics and discharge me/my student to an ambulance if I am not able to authorize it in case of a medical emergency. I certify that my student is in good health and capable of participating in physical activities.
I hereby give permission to Downtown Dance to take and use photographs for promotional uses for the studio.

I understand that payment is not refundable after June 1, 2016.
Guardian's Full Name (Signature to this agreement)*
Date*
My Products
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Princess or One Day Camp$75.00

Two Camps$150.00

Three Camps$225.00
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Downtown Dance: Princess & One-Day Summer Dance Camp Registration Form