LLLA Summer Camp Reg Form | Dance With Me Produc

LLLA Summer Camp Registration Form

Please take a moment to fill out the form.

*This form must be completed for each student attending camp. Failure to submit this form may result in forfeiting your child’s spot.*

First Name

Last Name

Phone

Select an Address

Child's Full Name

Birthday

Does your child have any allergies? (food, medication, environmental)

Does your child have any medical conditions or special needs we should be aware of?

Does your child require any medication during camp hours?

Name

Relationship to Student

Phone Number

Name & Phone Number

Your Signature

Thanks for submitting!