25-26 CDT LDT Dance Clinic

Item Description			Price	Qty
	CDT LDT Dance Clinic		$30.00
Dancer's First Name Dancer's Last Name Dancer's Grade* Parent's Name Parent's Email Parent's Phone Number Emergency Contact Name and Phone Number Additional Emergency Contact Name and Phone Number Allergies we should be aware of? Type N/A if not applicable. Medical Release I hereby give my permission for any and all medical attention necessary to be administered to my child in the case of an emergency. 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. Typing my name is in lieu of my signature. Media Release I, the undersigned, do hereby grant permission to Creekwood Dance Team & Longhorn Dance Team to capture and post my dancer’s photo and video material on the CMS/RMS website, and official social media accounts. Typing my name is in lieu of my signature.

Check-in begins at 9:00am