Bulldog Boogie '17 - "Blast From The Past" Participant Registration Form
Please fill out and submit one form for each participant.

Registration Deadline is September 19, 2017

A $30 registration fee payable to Judge Memorial will be due on Tuesday, September 19.
Payment may be brought to the first clinic on September 19, or may be mailed prior to:

Judge Memorial Catholic High School
650 South 1100 East
SLC, UT 84102

First Name of Participant
Your answer
Last Name of Participant
Your answer
My child would be most comfortable performing with one of the following dance groups...
*We will make every effort to honor your request but it may be necessary to combine groups depending on number of participants.
Current School Attending
Your answer
Current Grade In School
Parent/Guardian Primary Phone Contact
Your answer
Parent/Guardian Primary Email Address
Your answer
Participant's Physical Address
Your answer
First and Last Name of an Emergency Contact
Your answer
Emergency Contact Phone(s)
Your answer
T-Shirt Size for Participant
A Bulldog Boogie T-shirt is included in the $35 registration fee.
Would you like to purchase additional T-shirts?
Additional Bulldog Boogie T-shirt(s) are available for advance purchase of $10 each. (See graphic below.)
Captionless Image
Required
If "yes", please indicate the number of T-shirts and the size(s)
Sizes available are: Youth S, M, L, XL, Adult S, M, L, XL
Your answer
Media Release
I hereby permit Judge Memorial Catholic High School to use, in whole or in part, photographs, videos, written extractions, and voice recordings of my child, in any medium, including but not limited to social media, for the purpose of promotion, marketing and other educational purposes of Judge Memorial. I agree that all rights of the above image(s)/sound(s) become the property of Judge Memorial.
Required
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