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Rising Stars Academy of Dance Camp Registration Form
Complete the online registration form and submit payment for Dance Camp by July 1, 2019 via friends and family
Pay Pal & Zelle: myrisingstarsacademy@gmail.com
Cash App: $RSAOD
Enter dancer's name and description of payment in the notes section
Dancer Name *
Your answer
Age and Grade *
Your answer
School *
Your answer
Parent Name *
Your answer
Telephone Number *
Your answer
Email Address *
Your answer
List emergency contacts and number *
Your answer
Does the dancer have any medical restrictions or allergies? If so please list them *
Your answer
What level of Dance
Please list all prior dance experience including teams and schools *
Your answer
Which session are you attending ? *
Please enter your name and date below:
I, the adult applicant, or I, the parent or legal guardian of the applicant listed above, hereby give approval of the applicant’s participation in any and all of Rising Stars Academy programs and activities registered above. I do waive, release, absolve, indemnify, and agree to hold harmless the organizers, sponsors, supervisors,participants, and persons involved in the operation of Rising Stars Academy programs for any claims arising out of injury or other loss to named applicant or any member of his/her family whether as a participant in the activities or as a spectator. I also give permission for Rising Stars Academy of Dance to take photos of me or my child to use for the website and for purposes of promoting the school. If any child exhibits behavior that is dangerous to himself/herself or to other students, Rising Stars Academy reserves the right to remove the child from the program. *
Your answer
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