Summer Camp Registration Form

Love 2 Dance Studio Summer Camp Registration
Student's Information:
Student's Name

First NameLast Name
Birth Date

MonthDayYear
Age
Gender

MaleFemale
Address
Previous Dance Experience
Parent/Guardian Information
Name

First NameLast Name
Cell Number

Area CodePhone Number
E-mail
Schedule
Extension Hours Required

YesNo
Preferred Week
Additional Preferred Weeks
Medical Concerns:
Allergies and severity thereof:
Injuries and/or physical/mental hindrances:
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Love 2 Dance Studio during the selected camp. In exchange for the acceptance of said child’s candidacy by Love 2 Dance Studio, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Love 2 Dance Studio and all its respective teachers, councillors, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against Love 2 Dance Studio including all instructors and affiliates, all participants and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all physical activities, including swimming.
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Love 2 Dance Studio Summer Camp Registration