Special Preferences: (cholov yisroel, pas yisroel etc.)
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Medical Information: Allergies
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I confirm that the above named camper/dancer is in good health and has had a physical exam within the past year. *
Carpool information: If anyone other than a parent will be picking up your child, please enter their name.
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Previous Dance Experience
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Please specify which weeks your dancer will be attending *
You may choose more than one week (June 24th - August 30th, 2019 )
Required
PLEASE READ AND SIGN
In case of an emergency and I cannot be reached, I authorize the staff of “A Time For Dance” summer camp to obtain whatever medical treatment deemed necessary for the welfare of my child. I further understand that I am financially responsible for all the fees and charges incurred of the rendering emergency treatment G-d Forbid. I have read and agree to the policies and procedures of Time for Dance camp” and give consent to my child’s participation in activities at A Time For Dance and hereby absolve and release “A Time For Dance” and staff for any lost property and from any liability for accident or injury.
Parent's Signature *
Typing your name here will serve as an electronic signature
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Today's Date *
mm/dd/yyyy
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To Complete Registration:
Your registration is not complete without full payment.
Please click the "Submit" button then click the link on the next page to pay the camp fees.