Dancer Registration | Reflections Dance

2026 SUMMER
REGISTRATION FORM

Child's First Name

Child's Last Name

Guardian's First Name

Guardian's Last Name

Birthday (MM/DD/YYYY)

Guardian's Cell Phone

Guardian's Email

I understand that I need to provide my child with a snack and a water bottle labeled with the child's name.

Please list any medical/health/allergy conditions that may be pertinent to dancing or general play activities:

I have read and accept the Liability Waiver form.View form here.

I have read and accept the Photo/Video Release Form.View form here.

Please select your item again to confirm payment ($)

ROYALTY DANCE CAMP - $65

PARENTS NIGHT OUT (One Child) - $20

PARENTS NIGHT OUT (Multiple Children) - $15

INT/ADV DANCE INTENSIVE - $100

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