Your Name:

Your Birthday:

Your Email:

Best phone number to reach you at:

Home Address:

If you are on Instagram, what is your user handle? (Please include parent and student if applicable)

What school district are you in? (This is used for scheduling purposes only)

What is your favorite color?

What is your favorite treat?

What is your favorite thing to do besides dance?

Are you allergic to anything?

Are there any medical issues I need to be aware of?

Emergency Contact: Please list Name and phone number.

If there is anything else you would like to add, please do so here.