Registration

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Please read the FAQ Page BEFORE completing the registration form. You can read it here: Frequently Asked Questions.

* Indicates required field

Dancer's Name *

First

Last

Are you registering as an individual or as a part of a group of 10 OR MORE? *

If registering as part of a group, what is the group's name (church, youth group, etc.)? *

tHE 5-7 age group & the 10-12 AGE GROUP are CLOSED. WE CANNOT ACCEPT ANY MORE DANCERS IN THIS AGE GROUP. for girls ages 5, 6, 7, 10, 11 and 12 CLICK HERE TO ACCESSWAIT LIST REGistRATION.

Dancer's Age (How old will the dancer be on July 9?) *

5 6 7 8 9 13 14 15

Dancer's Birth Month *

January February March April May June July August September October November December

Dancer's Birth Date *

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Dancer's Birth Date *

17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Dancer's Birth Year *

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Dancer's Address (Don't miss Praise Movement birthday mail!) *

Line 1

Line 2

City

State

Zip Code

Country

Parent's First Name *

Parent's Last Name *

Parent's Phone Number *

Email (IMPORTANT camp info will be sent here) *

In case of an emergency, who should we contact? (#1) *

Phone Number *

Relation to Dancer *

In case of an emergency, who should we contact? (#2) *

Phone Number *

Relation to Dancer *

Dancer's T-Shirt Size *

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? *

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? *

Does the dancer have any food allergies? *

Yes No

If yes, please explain in detail. *

Does the dancer have any serious illness(es) or medical condition(s) we should know about? *

Yes No

If yes, please explain in detail. *

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 orresponsible 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. *

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. *

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. *

Yes No

This form is invalid without payment.
After CLICKING "submit", YOU WILL BE AUTOMATICALLY DIRECTED to the "Submit Payment" page.

Submit

tHE 5-7 age group & the 10-12 AGE GROUP are CLOSED. WE CANNOT ACCEPT ANY MORE DANCERS IN THIS AGE GROUP. for girls ages 5, 6, 7, 10, 11 and 12 CLICK HERE TO ACCESSWAIT LIST REGistRATION.

This form is invalid without payment. After CLICKING "submit", YOU WILL BE AUTOMATICALLY DIRECTED to the "Submit Payment" page.

This form is invalid without payment.
After CLICKING "submit", YOU WILL BE AUTOMATICALLY DIRECTED to the "Submit Payment" page.