Holiday Camp Registration - JJ DANCE Performing Arts Studio

Child's Name*
Birth Date*
MM slash DD slash YYYY
Age*
School
Medical Information
Medical Conditions
Contact Information
Parent(s) or legal guardian*
Email*
Phone*
Emergency Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Classes
Check the boxes beside the classes you wish the above child to be registered for. Your total due will be calculated below.
Holiday Dance Camp
Price:
Drop off 8:30-9am | Camp 9am-4pm | Pick up - 4pm-4:30pm | December 28-30 | 3 days - $99.00 plus hst | Age 5-12
Payment
Subtotal
$ 0.00 CAD
Tax
$ 0.00 CAD
Total
$ 0.00 CAD
Release & Liability
I hereby agree to not hold Jennifer Johns Main and staff responsible for any damages or liability due to theft, accident, or injury during or resulting from my child’s participation in any capacity of or relating to any function or activity of the said JJ Dance Performing Arts Studio. I/We give JJ Dance Performing Arts Studio permission to use any pictures video taken of me, or my child for advertising purposes.*
- I agree to the above terms
Credit Card
Card Details
Cardholder Name

Medical Information