CREATIONS YOUTH DANCE GROUP Registration Child's Name Age Date of Birth Food Allergies Previous Dance Experience Parent/Guardian Name PARENT/GUARDIAN (1-Primary): Email Address Phone Address Parent/Guardian Name PARENT/GUARDIAN (2): Email Phone Address CANCELLATION POLICY No refunds issued for natural, unexpected, unforeseen and uncontrollable environmental events. Name EMERGENCY CONTACT 1): Phone Additional Phone Name EMERGENCY CONTACT 2): Phone Additional Phone DOCTOR NAME EMERGENCY MEDICAL CONTACT DOCTOR PHONE Does child have any special medical considerations? SCHOLARSHIPS SCHOLARSHIPS Are you requesting a scholarship? Yes Please briefly explain why a scholarship is needed, the amount you can contribute towards your child's tuition, and why your child is interested in dance. 8 + 4 = Submit About the Program Registration Registration Fee & Monthly Payment Setup