Junior Pantera Dance Clinic Registration Form
Please fill out the below form completely and click submit. After clicking submit, you will be directed to a page with a PayPal button. Click on this button to be directed to PayPal to pay online. Otherwise, you can close the browser and pay at the door on the day of the event.


Junior Pantera Dance Clinic
Saturday, September 29, 2018
9:00 am - 12:00 pm
Colleyville Heritage High School Gym 2

Sponsored by: Ambition dance productions
4 yrs to 8th grade
Perform at October 12th pregame

(Enter gym doors across from tennis courts)
For more information: Contact Clinic Chair: tlchamp@swbell.net

Email address *
Sponsored by AMBITION DANCE PRODUCTIONS ambitiondancepro.com
Parent Name *
Your answer
Parent Phone *
Your answer
Student Name *
Your answer
Student Grade *
Your answer
Student School *
Your answer
Student T-Shirt size? (included) *
Mom T-Shirt size? Pre-order and pay $10 at pick-up the day of the clinic. *
Which Pantera referred you? *
Payment Options *
Any allergies that we should know about?
Your answer
Comments and/or questions
Your answer
Release of liability: My child has permission to participate in Pantera Jr. Dance Clinic. I understand that GCISD, its coaches, sponsors, and directors are released from all liability for personal injury and/or damages to personal property. *
A copy of your responses will be emailed to the address you provided.
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