Recreational Dance Camps

~ Registration Form ~

July 21-25 / Aug. 4-8 / Aug. 18-22

Dancer’s Name: ______________________________________________

Mailing Address: ______________________________________________

Home Phone # _______________________________________________

Other Phone # ________________________________________________________

Dancer’s Current Age __________ Date of Birth ____________________

Name of Parent/Guardian ______________________________________

Which week(s) are you registering for? _____________________________________________________________

Full Day or Half-Day Program? (If selecting half-day please specify morning or afternoon)

_____________________________________________________________

By signing below I agree to release Penticton School of Dance (and its instructors) from any responsibilities if an injury should occur to my child in class.

Parent/Guardian Signature ______________________________________

Date _________________________________________________________

Fee Enclosed: $ ____________ (cheques payable to Penticton School of Dance)

Credit Card # _________________________________________________

Expiry Date _____________

Any allergies or medical conditions that we should be aware of?

__________________________________________________________________________________________________________________________

Full Day Fee: $175.00

Half-Day Fee: $ 95.00

Drop off or mail registration to:

221-1475 Fairview Rd.

Penticton, BC V2A 7W5