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Boo Bash Dance Camp Registration 
Thank you for supporting the North Central High School Dance program! We look forward to sharing our love for dance with your child! Proceeds from this event will benefit the North Central High School Dance Program. 

Please  complete the form below to register your child. The cost of this event is $20 per child. Only cash payments will be accepted on the day of the event. More information will be shared via email before the event. If you have any questions please contact Mrs. Adams.

Regina Adams 
North Central High School Dance Teacher
regina.adams@kcsdshools.net 

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Email *
Child's First Name *
Child's Last Name  *
Child's Birthdate  (must be 5-12 years of age) *
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Child's Current Grade In School  *
Parent/Guardian First and Last Name  *
Parent/Guardian Phone Number *
List any allergies your child has. We will be providing a snack and candy so please let us know if there is something your child should not have.  *
Please list a 2nd emergency contact (The parent/guardian listed above will be the primary.)

Emergency Contact's First and Last Name 

 *
2nd Emergency Contact Phone Number  *
If you learned about this event from a North Central High School dance student, please list their name here.  *
A copy of your responses will be emailed to the address you provided.
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