Starz Unlimited First Time Clogger Camp 2015 Registration

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Our First Time Clogger Camp is for anyone ages 6 or older who has never tried a clogging class before.
ONE SESSION (4 days) of this camp per new dancer is completely FREE! No shoes clogging shoes are needed! We have selected sizes at the studio, and gym shoes will work great as well.

Parent/Guardian First Name *

Parent/Guardian Last Name *

Address- Street *

City *

Zip Code *

Home Phone Number *

Cell or Emergency Phone Number *

Email Address *

Dancer First Name *

Dancer Last Name *

Dancer Age *

Dancer Birthdate *

mm/dd/yyy

If you are new to Starz Unlimited, who referred you to our studio?

First Time Clogger Camp *

Session 1 - June 15-18 Ages 6-8- 2:00-3:00 p.m.

Session 1- June 15-18 Ages 9+ 1:00-2:00 p.m.

Session 2 - August 3-6 Ages 6-8- 2:00-3:00 p.m.

Session 2 - August 3-6 Ages 9+ 1:00-2:00 p.m.

Release of Libility *

Parents and students are aware that there is an inherent risk in physical activity and will assume risk as such. I accept full responsibility for any injury which the persons who are enrolled in classes at Starz Unlimited might incur while at Starz Unlimited dance classes or at any location while attending a function related to Starz Unlimited. By registering for classes, camps, or workshops I agree to indemnify (reimburse), release, and forever hold harmless Starz Unlimited Inc. for any claims, demands, and actions or causes of action on account of injury or loss or damage which may occur from any cause, without regard to negligence, other than gross negligence or willful misconduct of Starz Unlimited Inc. either for myself, for my children, and for children not directly involved with Starz Unlimited Inc, who accompany me and are in my care.

Required

Would you like to register another dancer?

Yes

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