DISCO RIOT SUMMER INTENSIVE REGISTRATION FORM

Join local dance company, DISCO RIOT, for a weeklong dance intensive! Classes will include contemporary and cultural dance techniques, improvisation, dancer toolbox sessions and more, with professional dance faculty.

JULY 25-29, 10 AM to 4 PM.

Co-ed camp for rising 9th -12th graders and adults.

$450 per participant

Participant Information

How many participants are you registering? (max 5) *

First Name *

Last Name *

Birth Date * +

Grade *

Please let us know if participant 1 play's a musical instrument and any artistic information to note. *

First Name - 2 *

Last Name - 2 *

Birth Date - 2 * +

Grade - 2 *

Please let us know if participant 2 play's a musical instrument and any artistic information to note. - 2 *

First Name - 3 *

Last Name - 3 *

Birth Date - 3 * +

Grade - 3 *

Please let us know if participant 3 play's a musical instrument and any artistic information to note.- 3 *

First Name - 4 *

Last Name - 4 *

Birth Date - 4 * +

Grade - 4 *

Please let us know if participant 4 play's a musical instrument and any artistic information to note. - 4 *

First Name - 5 *

Last Name - 5 *

Birth Date - 5 * +

Grade - 5 *

Please let us know if participant 5 play's a musical instrument and any artistic information to note. - 5 *

Current Total:

$0.00

Parent / Guardian Information

Relationship to Participant(s): *

First Name *

Last Name *

Address 1 *

City *

State *

Zip *

Phone *

Email Address *

Health Insurance Information

Participant First Name *