Mom's Morning Out Registration Form
Please fill out the below form completely and click submit. All fields marked with a RED asterisk is a required field and must be provided. 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.

GENERAL INFORMATION

Mom's Morning Out
Saturday, December 15, 2018
10:00 am - 2:00 pm
Ages: Boys and Girls 4 yrs to 6th grade
Cost: $25 per child ($20 per sibling)
Colleyville Heritage High School Gym 2 & 3

Sponsored by: Ambition dance productions

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

Email address *
Parent Name *
Your answer
Parent Phone *
Your answer
Number of children I am registering below *
Student #1 Name (required), Grade and School (if applicable) *
Your answer
Student #2 Name (required), Grade and School (if applicable)
Your answer
Student #3 Name (required), Grade and School (if applicable)
Your answer
Student #4 Name (required), Grade and School (if applicable)
Your answer
Student #5 Name (required), Grade and School (if applicable)
Your answer
Which Pantera referred you? *
Payment Options: $25 per child ($20 per sibling) *
Allergies: Please specify all allergies or diet restrictions for any child listed above.
Your answer
Comments and/or questions
Your answer
I consent to my child being photographed by the CHHS Dance Department. *
Required
Release of liability: I grant permission to all children listed above to participate in Mom's Morning Out. I understand that GCISD, its coaches, sponsors, and directors are released from all liability for personal injury and/or damages to personal property. *
Required
A copy of your responses will be emailed to the address you provided.
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