Tumbling For Dancers Registration

Parent or Guardian Name:*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Second Contact Information (as needed)
Dancer's Name*
First Last
Dancer's Birthdate*
MM
DD
YYYY
May we have permission to use your child(rens)’s image in publicity online (social media and website) and in print?*
- Yes
- No
Is there anything we need to know about your child(ren)?*
Other comments:*