2020 KCSAHDA Membership

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Please complete this form for your 2020 Kansas City St. Andrews Highland Dance Association membership. You will need to complete one form per member. Deadline is January 31, 2020. Payment can be turned into Laura Olson at 6914 W 66th Terr. Overland Park Kansas 66202

Email *

Member Name (First and Last) *

Member Birthdate (Year optional) *

YYYY

Membership Type *

Associate ($10)

Full ($15)

Dancer/Teacher ($15)

Dancer Level (If applicable)

Beginner

Novice

Intermediate

Premier

Clear selection

Member's Teacher (If dancer)

T-Shirt Size (ordered for full members and dancer/teacher members only)

XXL

Other:

Clear selection

Address (Street, City, State, Zip) *

Preferred Phone Number *

Guardian Name (If member is under 18)

Guardian Preferred Email (If different from member)

May we publish your contact information in a directory for members? *

Yes

I agree that KCSAHDA can publish photographs of you/your child(ren) in publications such as the website, social media, newsletter, event programs, and news releases. I understand that names will not be used to identify dancers on the website or social media unless permission is given. *

Yes

Form of Payment - Payment can be turned into Laura Olson at 6914 W 66th Terr. Overland Park Kansas 66202 *

Cash

Check (Make checks payable to KCSAHDA)

Submit

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