WDA Winter Intensive Registration Form
We can't wait to spend a week nurturing continued creative growth with your child!

Please fill out this form by January 25, 2020 to secure their spot in our program. All payments for the intensive must be made by cash, check (made out to Kristin Wagner), or Paypal (send as "friends and family" to kristin@ladybosproductions.com) by February 1, 2020. Payments are non-refundable.

If you are registering more than one child for the intensive, please register each child independently by completing multiple forms. If you have any questions or concerns, please email kristin@ladybosproductions.com.

Email address *
Parent's First and Last Name *
Your answer
Child's First and Last Name *
Your answer
Home address *
Your answer
Parent's Phone Number (primary) *
Your answer
Parent's Phone Number (secondary) *
Your answer
Please list two emergency contacts for your child, including first and last name, relationship to child, and phone number. *
Your answer
Age of your child *
Your answer
Please choose which package you are registering your child for: *
Pre-registration is not required for Drop In Technique classes, but having this information ahead of time is helpful! If you know what classes your child will be dropping into, please indicate below.
If you are registering your child for the full intensive, is your child able to commit to the March 12 "...that's what she said" performance?
Will you be paying by cash, check, or Paypal? *
Dance is a physically, mentally, and emotionally engaging activity. Does your child have any injuries, allergies, or any other special considerations that our instructors should consider while planning and teaching class? *
Your answer
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Kristin Wagner. Report Abuse