SUMMERREGISTER

Student Name *

First

Last

Date of Birth *

Age *

Daytime Classes

Evening Classes

5:30-6:30 *

None Combo - Thunder and Laser

6:30- 7:30 *

None Combo - Lazer/Bionic/Sonic STJ Atomic/Elite

7:30-8:30 *

None Combo - Bionic/Sonic/Atomic/Elite

Parent/ Guardian Name *

First

Last

* Indicates required field

Primary Email *

Primary Phone Number *

Primary Address *

Line 1

Line 2

City

State

Zip Code

Country

Please specify any special conditions or allergies. *

Medical Consent *

I Agree

Media Release *

I Agree

I approve of my child’s participation in Vibe Performing Arts programs, and certify that he/she is in good health and able to participate in the program. If medical attention is required for illness or injury, I grant permission for such care to be rendered.

I authorize images and videos to be posted on websites and social media that may be taken during events coordinated through Vibe Performing Arts.

Summer Intensive Registration

Daytime Classes

Evening Classes

Please Save this page before submitting