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REGISTER | Recalibrate: Summer Intensive
1
Dancer's Full Name
*
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First Name
Last Name
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2
Dancer DOB
-
Date
Year
Month
Day
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3
Dancer's Email
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example@example.com
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4
Parent/Guardian Full Name
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First Name
Last Name
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5
Parent/Guardian Contact Number
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Please enter a valid phone number.
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6
Parent/Guardian Email
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example@example.com
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7
My Products
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My Bag
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My Bag
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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ORDER SUMMARY
Total cost
AUD
3 Days - $350
Full 3-day intensive registration
$
350.00
AUD
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Quantity
Single Day - January 16th
Single day attendance on January 16th
$
135.00
AUD
+
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Quantity
Single Day - January 17th
Single day attendance on January 17th
$
135.00
AUD
+
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Quantity
Single Day - January 18th
Single day attendance on January 18th
$
135.00
AUD
+
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First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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8
I acknowledge photos/videos may be taken during the intensive for promotional use by Scimm. Dance.
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9
I understand this is a physical activity and declare the dancer is fit to participate.
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