EmailMe Form - TITN 2019: Beginning & Intermediate Registration

Dancer First Name *

Dancer Last Name *

Parent or Guardian First Name

*Required if under 18 years of age.

Parent or Guardian Last Name

*Required if under 18 years of age.

Dancer's Age *

Birthday *

MM / DD / YYYY

Home Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Phone *

### - ### - ####

Secondary Phone

### - ### - ####

Email *

Confirm

T-Shirt Size *

Event(s) Attending *

How did you hear about us? *

Tap Training *

How many years has the participant been training in tap dance?

Home Studio Name *

If you are not affiliated with a home studio, please write "Independent"

Tap Instructor Name

Who is your primary tap instructor? Only one name is necessary. Not required if you're not affiliated with a home studio.

Signature Name *

First Last

Participant signature. If the participant is under 18yrs, then a legal parent or guardian must sign.

Liability & Medical Release *

Clear

To make registration easier this year, we are incorporating an electronic Medical Release Form rather than requiring a signed copy to be printed and turned in at the event.

By signing and submitting this e-form, you agree to the terms and conditions stated within our Medical Release Form found on our website footer, and by Clicking Here

Message (Not Required)

If you received a scholarship please let us know. Any other questions or comments you can leave here as well.