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2026
DANCER
REGISTRATION

Dancer/Child's Date of Birth
Month
Day
Year

For the safety of your child, please make The Dance Workshop aware of any specific custody or visitation rights by either parent. If you do not reveal this information, we will assume either parent may pick up your child at any time.

Please list any medical concerns or physical limitations that may affect your child’s performance in any class taken at The Dance Workshop.

If your child requires an inhaler, EpiPen, etc., please explain how this medication should be given if needed at the dance studio. If an emergency action plan is required, please supply a copy to The Dance Workshop.

To my knowledge, the information given is accurate.

If there is a dance category you are not registered in from registration night but are interested in please indicate below.
Choose the appropriate option for the Dancer you are completing the form for. *If this is your Second Dancer Choose only the second box. **If this is your third plus leave this section blank.
Insurance Fee
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