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Summer Camp Form 2023
Please fill out the form below to start your registration for summer camps. If you have any questions, contact Uplift Dance at 224-828-0801 or upliftdanceducation@gmail.com
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Email
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Your email
Where did you hear about us?
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Email
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Your answer
Phone Number
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Parent's First & Last Name
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Your answer
Dancer's First and Last Name
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Your answer
Student's Birthday & Age
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Your answer
Address
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Today's Date
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Use of child photo on Uplift Dance Education social media and website
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Emergency Contact & Phone Number
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Health Conditions or Allergies
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Parent/Guardian/Adult Participant Initials:
I hereby give consent for the above named person to participate in dance and/or other physical activities under the direction of Uplift Dance Education
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Camp Options:
3 Day Camps- $120, 2 Day Camp-$90, & 1Day Camp-$50
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Bluey Dance Camp- August 1st, 2nd, 3rd 1pm-3pm Ages 2-5
Required
Uplift Staff will follow-up with this form to confirm your selections.Payment is due to secure your dancer's spot. There is a processing fee of
3.05% + $0.30
per transaction for credit or debit cards. Pay cash or check to avoid the processing fee. Please sign below with your initials and date.
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A copy of your responses will be emailed to the address you provided.
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