Dancin'Clusion
Summer Dance Program Online Registration
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Email *
_____________________ will be participating in Dancin’ Clusion’s 6 Week Summer Dance Program. This program entails 2 weekly hour dance classes for the duration of the program. In these classes, dancers will stretch to their capability, practice dance technique, and learn a short, simple routine with the help of a “buddy.” The styles of dance that will be taught are jazz and tap. (Please write your child's name below) *
Dancer Name: *
How old is your child? *
What is your child's date of birth? *
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What grade is your child in? *
What is your address? (Please include town, state and zip code) *
What is your child's T-Shirt size? (please specify if it is a child or adult size) *
Parent/Guardian Name: *
Date: *
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Email: *
Phone Number: *
Preferred method of contact: *
Alternate Emergency Contact - Name: *
Alternate Emergency Contact - Relationship to Dancer: *
Alternate Emergency Contact - Phone Number: *
Please feel free to tell us a little bit about your child! *
A copy of your responses will be emailed to the address you provided.
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