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Swing Dance June 29th, 2019 Registration Form

All participants must be 13 years old by June 29th, 2019.


Circle one:
Please print:

Name:__________________________________ Age:_________ Gender: M F

Name:__________________________________ Age:_________ Gender: M F

Name:__________________________________ Age:_________ Gender: M F

Name:__________________________________ Age:_________ Gender: M F

Your Address and Phone Number:


________________________________________________________________
________________________________________________________________

Your Email (for confirmation and updates).


________________________________________________________________
________________________________________________________________

How you learned about this event (include homeschool group name or who
invited you, etc.):
________________________________________________________________
________________________________________________________________

Make checks payable to and send to:

Abbey Schneider
8947 Wilson Rd
Waynesville OH 45068

-Only those with paid registration will be permitted in the banquet hall.
-Registration is non-refundable.

By completing this form and signing below I understand that the organizers,
assistants, and all other participants are not responsible for any injuries that may
occur before, during, or after this event. I also agree to abide by the dress code
and guidelines for this event.

X________________________________Current Date: ___________

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