Dance Clinic Registration

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Free Dance Clinic with Packatahnas

Email *

Student's Name *

Student's Grade *

Grade 6

Grade7

Grade 8

Would you like information about tryouts and future camps sent to you? *

Yes

Parent name *

Parent email *

Parent phone number for Emergency contact *

Please Acknowledge: *

I understand that WFPS and the Packatahnas do not supply medical insurance nor will they be responsible for any medical expenses. I hereby authorize WFPS staff to act for my child to their best judgment if any emergency requiring medical treatment should occur. I waive and release staff from any and all liability of any injury. I also verify that my child is medically fit to participate in this activity.

Required

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