Elegant Princess Diamonds Registration Form

Which activity are you interested in?

CheerDanceTwirl and Flag
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Welcome to Elegant Princess Diamonds Dance and Cheer Team! We are excited that you are interested in our organization! Please fill out the information below .
Athlete Information
Dancer / Cheerleader Name*

First NameLast Name
Dancer/ Cheerleader Name*

First NameLast Name
Dancer / Cheerleader Name*

First NameLast Name
How old is your dancer/cheerleader?
How old is your dancer/cheerleader?
Guardian / Parents Names*

First NameLast Name
Cell Phone

Area CodePhone Number
E-mail*

Dance /Cheer skill level*

	1	2	3	4	5

1 is Begginer, 5 is Advanced

Important Notes ·

YOUR CHILD CANNOT DO BOTH ! SHE HAS TO PICK!

CHEER OR DANCE

Dance Information:

Location - 6805 Patrol Way Dallas Tx 75241

New member starts November 1, 2023 6:00PM -8:00 PM

Registration is Free for both !

Cheer Information:

Location - 6805 Patrol Way Dallas Tx 75241

New Members start November 1, 2023 6:00 PM - 8:00 PM

You will recieve an email with all the information you need for your cheerleader.
Emergency Contact & Health Insurance Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?*

YesNo
Please describe*
Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.
Name of Physician / Emergency Medical Care Facility
Phone Number

Area CodePhone Number
Confirmation E-mail*
Signature*

Clear
After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at awren10@gmail.com
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