Fillies Junior Dance Clinic Registration 2019

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Please fill out the form and make a payment through our PayPal link to complete the registration process. You do not need to have a PayPal account to pay online, all you need is a credit card or a debit card.

Email *

EARLY REGISTRATION DEADLINE FOR SPECIFIC TSHIRT SIZE IS 10/12 !

Participant's Last Name *

Participant's First Name *

Parent's Name *

Parent's Phone Number *

Parent's Address *

How did you hear about this event? *

Fillie or Fillie family personally invited me.

I saw a sign while driving or in a local business.

I received a flyer from school.

I received an email reminder because I attended last year.

Social Media.

Name of Fillie who invited your child.

Child's School Name *

Child's Grade Level *

Kindergarten

First

Second

Third

Fourth

Fifth

Child's T-Shirt Size *

Youth Small

Youth Medium

Youth Large

Youth Extra Large

Adult Small

Adult Medium

Adult Large

Emergency Name and Contact Phone Number *

PayPal Link

https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=VTQBEUK3NC54C

You can pay with paypal, credit card, or debit card using the above link. *

I have paid $40 for my registrant using the paypal link above.

I give my child permission to participate in the Fillies Dance Clinic on October 19th, 10am-1:30pm. *

Yes

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