Flint River Dance Arts

Fairytale Dance Camp 2012 Registration Form

July 23-26
A $50 deposit must accompany this form

(It will go towards your tuition)

Name: ___________________________________ Age: _____

Grade (fall 12): _____

Address: _____________________________________________________________________
City/State/Zip: _________________________________________________________________
Parent/Guardian Name: _________________________________________________________
Contact Information: ___________________________________________________________
Address if different from child: __________________________________________________
Please check one of the following:
Entire Week: ____One Day: ____
If not entire week please explain what day/times you will be taking:
___________________________________________________________________________

Tuition for the Entire Week

$80 before June 15

$100 after June 15

Please contact Leslie Hodges with any questions.

flintriverdancearts@gmail.com