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Free Summer Dance Camp (Dance Forms Throughout the Years)
Monday-Friday, August 12-16, 9am-4pm 
Cultural Arts Center at Disciples Church, 3663 Mayfield Road, Cleveland Heights, OH 44121
Please fill out the responses below and submit. Thank you!
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Camper's name *
Camper's age (camp is for ages 10-14) *
Camper's name (if you have a second camper)
Camper's age (camp is for ages 10-14) *
Camper's name (if you have a third camper)
Camper's age (camp is for ages 10-14)
Parent/Guardian Name

*
Parent/Guardian Email and Phone Number *
Emergency contact Name and Phone Number *
Is there anything that would be helpful to know about the camper?  *
Are there a day that your camper will miss, arrive late and/or leave early (only once absence and one tardy or early deptarture is allowed)?  If so, please share...
How did you hear about this camp?  *
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