$170 per Camp (150+ hst)

___     July 4th – 8th
___     July 11th – 15th

___     Aug 8th – 12th
___     Aug 15th – 19h

Name______________________Age________
Health Card # _________________________
Address ____________________________________________
Phone # Day  _____________ Evening ________________
Emergency Contact if no answer
Name _______________________________________________
Phone # ____________________________________________
Relationship _______________________________________

I give permission for my child to attend Dance Pointe’s Dance Camp Program.

Students are responsible for their own Insurance and any loses incurred are not

the responsibility of Dance Pointe.

Parent/Guardian Signature

____________________________________________________