Teen/Senior Registration

Dancer's Name *

First Name

Last Name

Days Attending *

July 15 | 8:30am-3pm ($30)

July 16 | 8:30am-3pm ($30)

Both Days ($50)

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Name *

First Name

Last Name

Parent Phone Number *

(###)

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I, the undersigned, have the authority to sign this release on behalf of all the persons registered above and/or attached for this workshop. Loss/damage of personal property or personal injury of those participating or attending. I also authorize Studio 28 Ministries and/or No Limits Dance Company to use images of the registered parties for advertising purposes. *

I agree