Red, White and Silver Dance Clinic Registration

Student

First NameLast Name

Student Grade Level

Student Age

Dancer Gender

Student E-mail

example@example.com

School

Teacher

T-shirt Size (select a size)

Lunch Preference (select one)

List any food allergies

Emergency Contact Name:

First NameLast Name

Emergency Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact #

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

Emergency Contact E-mail

Confirmation EmailRegistration confirmation will be emailed to this e-mail address

Consent to Leander ISD and the Vista Ridge Star Steppers to take pictures and videos featuring my child during this clinic that may or may not be posted online or through social media by LISD or VRHS Star Steppers.

Select One

Payment Options

Pay by SQUARE

Red, White & Silver Dance Clinic

EARLY REGISTRATION

$45.00

Subtotal

Shipping

Total

Credit Card

Pay by Venmo Instructions:

After you submit your form, please send your payment via VENMO using @VRHSStarSteppers-BoosterClub

Pay by Check Instructions:

After you submit your form, please mail a check payable to VRHS Star Steppers to the address below:

Vista Ridge High School
ATTN: Star Stepper Booster Club
200 S. Vista Ridge Blvd
Cedar Park, TX 78613

By submitting this form, you hereby have REVIEWED and AGREE with the following waiver:

WAIVER OF CLAIMS: "I hereby release any claim I might have against Leander Independent School District, or any of its agents, which might arise from any injury or other damage my child might incur while on the property of LISD or while participating in any activity sponsored by LISD."

Student Information

Emergency Contact Information

PHOTO/VIDEO RELEASE

Clinic/Workshop Fee

Pay by SQUARE

Credit Card