SUMMER CAMP

2022 SUMMER CAMP
REGISTRATION FORM

Student's Name *

First

Last

Date of Birth *

Parent's Name *

First

Last

Email *

Phone *

School *

Address

2ND EMERGENCY NAME: *

2ND EMERGENCY CONTACT: *

How did you hear about us? *

June Camp Tuition

July August Camp Tuition

Please check to give us permission to take photographs of your child for our gallery, website, and social media. *

Thank you for your interests for Athena Dance Academy! We will be in touch with you shortly for payment and class details. Comments or Questions?