SUMMER REGISTRATION FORM

Summer 2022 Registration Form

Student First Name

Student Last Name

Student's Date of Birth

Parents/Guardians Names AND Phone Number

Contact Email

CLASS SELECTION

DANCE CAMP (July 25 - 29)

CDP INTENSIVE (August 15-19)

ACRO INTENSIVE (August 03)

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Emergency Contact Name(s) AND Phone Number(s)