Jupiter Dance Academy Summer Camp 2023 Registration Form
Thank you for considering the Jupiter Dance Academy 2023 Summer Camp Program. We are excited to offer a fun, educational, and entertaining Summer Camp. Please complete this form and then click the link at the bottom of the form to complete our internal systems registration form where you will sign our camp policies and enter payment information. If you have more than 1 camper joining us then please complete 1 google form for each camper. Please contact our Studio Manager, Emily Mosher with any questions at emilyjupiterdance@gmail.com. 
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Email *
What is Your Camper's Full Name and Date of Birth *
Parent's Name, Phone Number, and Email (Mom) *
Parent's Name, Phone Number, and Email (Dad) *
Please select from the following:  *
Will your child be dropped off before 9:00am? We are offering early drop off as early as 8:00am for $10 additional per day. Please mark below if you would like to chose this option. 
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If you chose "Dance Class Only" - please check which days they will attend and which camp weeks they will attend. 
Please mark all camp weeks that your Dancer will attend.  *
Please list below all persons that are authorized to pick up your child. We will require Photo ID from everyone other than Mom or Dad. 
Please list below any allergies. 
Please mark below that you agree to the following: 
Each camper should bring: a water bottle labeled with their name, a snack (must be nut free), and lunch for full day campers (must be nut free). Each camper should wear: clothing that is comfortable to do a variety of dance styles in. 

Please note that if your child is not picked up 15 minutes or more after the scheduled pickup time, your account will be charged $15. 
IMPORTANT: Please click the link below to register your child through our internal system. Registration is not complete until you have completed the form linked below. After you have completed the form, your total tuition will be added to your account and charged to the card on file based on your answers above.If you would like to pay by cash or check, please notate that in the box below. https://app.jackrabbitclass.com/regv2.asp?id=543179
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