25-26 Kingwood Fillies Dance Clinic Registration Form

Come join the award-winning Kingwood Fillies for a fun day of more than just dance! Each participant will receive lunch, one snack item, and a clinic t-shirt. *

Date: Saturday, October 4

Location: Kingwood High School, sports commons entrance

Time: 10:00 AM - 3:00 PM (parent show will begin at 2:15 PM in the main gym)

Pre-K, Kindergarten, & 1st grade - check-in begins at 9:25 AM
2nd - 5th grades - check-in begins at 9:40 AM

Cost: $75 per dancer (For an additional $25, Pre-K - 5th grade dancers can sit with a Fillie in the stands prior to halftime - REGISTER EARLY for this opportunity)

Clinic Registration Includes:

Lunch: Chick-fil-A nuggets, chips, cookies, and water
Concessions stand: One complimentary snack item will be provided; additional snacks and drinks can be purchased for $1 per item (Cash only - please pack your dancer cash)
Clinic t-shirt: *Must register by September 17th to guarantee t-shirt
Pre-K - 5th grade halftime performance opportunity: Gather with the Fillies before halftime and dance on the field at the Friday, November 7 Kingwood varsity football home game at Turner Stadium

Raffle:

Tickets are available online and will also be sold at the clinic during check-in. Online orders will be picked up at check-in. Examples of items that may be offered:

Pre-K to 5th grade dance party
Various outings with the Fillies
Sit with the Colonel in stands prior to November 7's halftime show
Merchandise bags & more

Please complete a separate registration form for each participant.

Item Description Price Qty

Dancer first and last name

Participant Grade:*

Participant's t-shirt size:*

Parent Email

Home Address

Parent to contact during clinic if needed

Parent Cell Phone Number

Secondary Contact Name during clinic if needed

*Please list a second person not listed above as an emergency contact

Secondary Contact Cell Phone Number to call during clinic if needed

Allergies

Lunch provided will be breaded Chick-fil-A nuggets, chips, cookie and water. Concessions will be nut free but items may contain other common allergens.

Medical Conditions

Photo Release*

I herby give permission for my child's photo to be taken by the Kingwood Fillies.

Medical Release*

I herby give my permission for any and all medical attention necessary to be administered to my child. I understand and accept that the risk of injury is possible while participating in any athletic/dance activities. I agree to accept full responsibility for any medical charges on my child's behalf.

Sign Name

By typing your name you consent to the medical release form.

Date

Kingwood Fillies Dance Clinic Registration
This registration includes dance clinic and half time performance at the November 7th football game (optional) more

$75.00

Kingwood Fillies Dance Clinic Registration & Sit With A Fillie
This includes registration to the Kingwood FIllies Dance Clinic and a ticket to Sit With A Fillie at our November 7th Game at Turner Stadium. more

$100.00

Sit With A Fillie Add-on
Use this to add Sit With A Fillie more

$25.00

Raffle Tickets 5 for $5.00 $5.15

Raffle Tickets 10 for $7.00 $7.21

Raffle Tickets 15 for $10.00 $10.30

Raffle Tickets 30 for $20.00 $20.60

25-26 Kingwood Fillies Dance Clinic Registration Form

Thank You for Your Purchase!