REGISTRATION FORM Parent or Guardian Name * First Name Last Name Second Parent or Guardian Name First Name Last Name Primary Phone Number * Email * Dancer Name * First Name Last Name Dancer Date of Birth * MM DD YYYY Dancer Medical Conditions Emergency Contact Phone Number (if different from Primary Phone Number) (###) ### #### Checkbox * I have read and agree to the Conditions of Registration I understand that the information I have submitted will not be shared with a third party without my permission Thank you! Conditions of Registration
