Parent #1 Full Name *

Parent#2 Full Name

Dancer's Full Name *

Dancer Age *

Parent Preferred Email *

Parent Preferred Phone Number *

Alternative Phone Number #1

Alternative Phone Number #2

Address *

City *

State *

Postal code *

Collect Payment *

Dance Intensive Deposit

This deposit secures your dancer’s place in our upcoming Dance Intensive Camp. Please note: this payment is a non-refundable deposit.

$75

*100% secure & safe payments*