Silver Wings Dance Clinic

Register your child for the annual Silver Wings Dance Clinic:

Child Information
Student's Name*
First Last
School*
Grade*
T-shirt Size*
Parent/Guardian Information
Parent/Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home Phone*
Mobile Phone*
Emergency Contact Information
Emergency Contact Name*
Emergency Contact Phone*
HHS Silver Wings Release of Liability:
I give permission for my daughter to participate in the Hebron HS Silver Wings Dance Clinic on October 19, 2019. I agree to and understand that although precautions will be taken to ensure the safety of my child, any injury that may occur during the clinic is not the responsibility of HHS or the Silver Wings Booster Club.
Release of Liability*
- I agree
HHS Silver Wings Photo Release :
HHS Silver Wings is a community outreach program and may reproduce and publish photographs taken on October 19, 2019. I agree that my child’s picture may be used in connection with articles concerning the dance clinic or with advertisement of future clinics.
Photo Release*
- I agree
Dance Clinic
Name
This field is for validation purposes and should be left unchanged.