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Special Event Registration

Special Event Registration Form

Event you are attending*

Student Name*

Age*

Student Name (2nd)

Age

Student Name (3rd)

Age

Student Name (4th)

Age

Parent Name*

Email Address*

Primary Phone Number*

Allergies or concerns we need to have on file for your child?

I have read & agree to all policies of the studio and consider this my signature of the waiver on this page. *

Signature (Your name)*

Questions or additional information

Waiver ~ Please read & agree to the following on your form

 

Proudly Serving the Hampstead community for 20 years!! 

Phone: 910.270.2525

E-Mail: DanceTumbleJ4K@gmail.com

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14880 US Hwy 17 N * Hampstead, NC 28443

mailing address - 502 Windemere Road, Wilmington, NC 28405

©2024

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