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P M S D C 2019
REGISTRATION
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Indicates required field
Dancer's Name
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First
Last
Is the dancer registering as an individual or as a part of a group of 10 OR MORE?
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Individual
Group
If registering as part of a group, what is the group's name (church, youth group, etc.)?
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Dancer's Age (How old will the dancer be on July 6?)
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8
9
10
11
12
13
14
15
Dancer's Birthday
Month
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January
February
March
April
May
June
July
August
September
October
November
December
Day
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1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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22
23
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25
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30
31
Year
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2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
Please upload Proof of Age for the dancer where her name and birth date are CLEARLY PRINTED. (i.e. birth certificate, medical statement, standardized test results) --- JPG (picture) is the best format.
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Max file size: 20MB
All PMSDC 2019 sessions (meals, biblical instruction, dance instruction) will follow a partnership structure. Since we will be "going to war" as a camp unit this summer, we STRONGLY recommend that every dancer register with a Battle Buddy. Veteran campers should invite someone who has never attended camp. We suggest that every dancer invite a sister, friend, classmate, cousin, or neighbor that they'll be able to go through the week with. Who is your daughter's Battle Buddy? Enter her name so we can connect the girls in our registration files.
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First
Last
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Dancer's Address (Don't miss Praise Movement birthday mail!)
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Line 1
Line 2
City
State
Zip Code
Country
Parent's First Name
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Parent's Last Name
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Parent's Phone Number
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Parent's Email (IMPORTANT camp info will be sent here)
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In case of an emergency DURING CAMP HOURS, who should we contact? (#1)
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Relation to Dancer
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Phone Number
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In case of an emergency DURING CAMP HOURS, who should we contact? (#2)
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Relation to Dancer
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Phone Number
*
Besides who's already been listed
,
please provide names and phone numbers for
authorized pick up persons
for your child.
Name
*
First
Last
Phone Number
*
Name
*
First
Last
Phone Number
*
Dancer's T-Shirt Size
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Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
What pant size (elastic waist) does the dancer normally wear?
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Youth S (Size 2-4)
Youth M (Size 6-8)
Youth L (Size 10-12)
Adult S (Size 2- 4)
Adult M (Size 6 -8)
Adult L (Size 10-12)
Adult XL (Size 14-16)
Adult XXL (Size 18-20)
Is there any additional information you'd like to give us concerning the dancer's pant size?
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Does the dancer have any food allergies?
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Yes
No
If yes, please explain in detail.
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Does the dancer have any serious illness(es) or medical condition(s) we should know about?
*
Yes
No
If yes, please explain in detail.
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Specialty Class
1st
Choice
Choose Any
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CHEER
FLAGS
STEP
Specialty Class
2nd
Choice
Choose Any
*
CHEER
FLAGS
STEP
Specialty Class
3rd
Choice
Choose Any
*
CHEER
FLAGS
STEP
Physical activity can sometimes cause minor mishaps to occur. Therefore, in the event a dancer sustains any injury, illness, or any other physical harm in connection with participation in the Praise Movement School of Dance, Inc. programs, I agree that neither the Praise Movement School of Dance, Inc, nor any of its instructors, employees, agents, or principles shall be liable or responsible for any claims, costs, liabilities, expenses, or judgments (including for example doctor fees, hospital expenses, and personal injury claims resulting from any such injury, illness, or physical harm.) The acknowledgement of risk and waiver of liability, having been read thoroughly and understood completely, is signed voluntarily as to its content and intent.
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Yes
No
Praise Movement School of Dance, Inc. believes that the word of God is the final authority by which our lives are governed. Hence, references to the word of God will be used inside and outside of dance instruction to teach Christian living principles and Christ-like behavior. • For dance instruction, Praise Movement School of Dance, Inc. only uses music that uplifts and praises God. The types of music we use are traditional gospel, contemporary Christian, and Christian rap. I have read the above statements, and I understand Praise Movement School of Dance, Inc.’s beliefs and teaching principles. I understand that Praise Movement School of Dance, Inc. is operated by these beliefs and principles and that my child is expected to honor them as long as she is a participant.
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Yes
No
I understand that all fees are non-refundable and the sessions may be changed, cancelled, combined, or rescheduled as required. In the event that the dancer registered above decides to discontinue the session, I will inform Praise Movement School of Dance by phone or e-mail, and I understand that I will not receive any refunds.
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Yes
No
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Dance with purpose!