Summer Camp Sign Up

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Summer Camp Sign Up

Location: 201 North Main, Osceola, IA 50213

Website: dancestudio201.com

Email *

Camper's Name *

Camper's Age *

Camper's Birthday *

YYYY

T-Shirt size *

YXS

YXL

AXL

Parent/Guardian's Name *

Phone Number *

Home Address *

Camps Attending *

Patriot Camp June 26-30 (Ages 3 and up)

Other:

Required

I, THE PARENT/LEGAL GUARDIAN OF THIS PARTICIPANT IN STUDIO 201 DANCE PROGRAM, HEREBY AUTHORIZE THE STUDIO 201 STAFF TO OBTAIN WHATEVER MEDICAL SERVICES DEEMED NECESSARY IN THE EVENT THE PARTICIPANT SUSTAINS AN ILLNESS OR INJURY IN MY ABSENCE. THIS AUTHORITY INCLUDES CONSENT TO ANY MEDICAL PERSONNEL OR FACILITY TO RENDER CARE AND TREATMENT AUTHORIZED BY THE STAFF. THE STUDIO 201 STAFF WILL NOT BE RESPONSIBLE FOR INJURY, THE COST OF MEDICAL TREATMENT OR TRANSPORTATION.

Yes

Clear selection

I understand that I will have to pay the camp fee before my dancer can attend. Please allow up to 24 hours for an invoice to be emailed.
*

YES

Send me a copy of my responses.

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