Passion Dance Center Summer Camp Audition Registration Form
Student Information
Student First Name *
Your answer
Student Last Name *
Your answer
Age *
Your answer
Birth date *
MM
/
DD
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YYYY
Street Address *
Your answer
City *
Your answer
State *
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Zip code *
Your answer
Parent Email Address *
Your answer
Social Media (i.e.. Instagram, Facebook, Twitter)
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Does the student have any ailments or restrictions? If yes, please explain.
Your answer
School Attending *
Your answer
Grade level *
Your answer
Any previous dance training? Yes or No *
Your answer
How many years has the student been dancing? *
Your answer
List Current or previous dance school(s) *
Your answer
How did you hear about us? *
Required
Parent Information
Parent or Guardian First Name *
Your answer
Parent or Guardian Last Name *
Your answer
Phone Number *
Your answer
Release of Liability *
As the legal parent or guardian, I release and hold harmless Passion Dance Center LLC, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Passion Dance Center, its owners and operators or in route to or from any of said premises. Entering your name below means you agree to the Release of Liability terms.
Your answer
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