Child's Name *

First Name

Last Name

Child's Birthdate *

MM

DD

YYYY

Grade during 2023-2024 *

If you do not see your child's grade listed, it is because the team for her age group is full. Please contact Caryn Oyler if you would like to be placed on a waiting list.

4th Grade

5th Grade

6th Grade

7th Grade

8th Grade

Parent/Legal Guardian #1 *

First Name

Last Name

Parent/Legal Guardian #2

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

If you are new to Dazzlers, how did you hear about us?

Friend

Internet Search

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Summer Camp

Other

I understand that Dazzlers, Christian Dance Studios Inc., and their employees are not liable for any injuries that may occur while my daughter, son, or family members are involved with lessons and activities on Dazzler property, or while participating in Dazzler related events; and agree to hold harmless Dazzlers and it’s employees from negligence, active or otherwise, of Dazzlers, it’s agents or employees. I also give permission to use photographs of my child for any future advertising purposes, on print or website format. *

I have read and agree with the statement above.