Summer Camp Registration Form
Register for our dance, gymnastics, and free play combo camp with Super Stars Dance and We Rock the Spectrum Kids Gym.
Participant's Full Name
*
First Name
Last Name
Participant's Date of Birth
*
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Month
-
Day
Year
Date
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Please list any allergies or medical conditions
Does your child have any allergies?
*
Camp week plus processing fee.
*
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June 1st-3rd
$190.00
$
190.00
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June 8th-10th
$190.00
$
190.00
Quantity
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June 15th-18th
$190.00
$
190.00
Quantity
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Credit Card
You understand that Dance and gymnastics are physical activities and you can not hold Super Stars Dance, their Employees or We Rock the spectrum Bellaire Facility or Staff accountable for anything that happens
*
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