Silver Wings Dance Clinic

Register your child for the 2021 Silver Wings Dance Clinic:

Child Information
Student's Name*
First Last
School*
School-Other
Grade*
T-Shirt*
Parent/Guardian Information
Parent/Guardian Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
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 16, 2021. 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 16, 2021. 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
The Hebron Silver Wings will be providing a snack for participants. If your daughter has specific food allergies or you would like us to know something specific, please email vp_fundraising@hebronsilverwings.org.
Administrative Fee*
Price:
Total
$0.00
Click Next to Complete Payment.
Phone
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