2019 Spring CONTEMPORIZE! Registration Form
Thursday, April 18

Mass Motion Dance
100 Holton St. Boston, MA
1-9pm (or half day option)

Email address *
First and Last Name of Dancer *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian Name *If Under 18
Your answer
Parent/Guardian Email *If under 18
Your answer
Address (city, state & zip code) *
Your answer
Contact Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Any health problems or allergies we should be aware of? *
Your answer
How long will you be attending? *
Scholarships & Discounts are only applicable to the FULL DAY rate*
Did you receive or qualify for a scholarship/discount? *
If yes, what is your discount code?
Your answer
Payment Amount *
Would you like to purchase a piece of NEW BCDP 2019 apparel for $12? *
I paid this amount of money (code and apparel included): *
Your answer
Payment Method *
I understand that I must Print Out, Sign, and Bring the form below to participate in CONTEMPORZIE!
*
To print image: right click, save image as
Thank you for registering for CONTEMPORIZE! We can't wait to dance with you!
A copy of your responses will be emailed to the address you provided.
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