Monday, July 30, 2012

TCDT 2012-2013 REGISTRATION

Tri-City Dance Twirlers Registration Dates
If you are twirling at a school location you can either register at one of our locations listed below or mail in the registration form to our studio address (3692 County Road 561 Tavares, FL 32778).

There is a registration fee of $35.00.
This includes a TCDT t-shirt, ribbons and tape for all parades, and glow products for our night parade.

REGISTER AT STUDIO:
3692 County Road 561
Tavares, FL 32778
Saturday, August 25th 10:00 am-12:00 pm
Friday, August 31st 5:00 pm-7:00 pm

REGISTER IN CLERMONT/MINNEOLA AREA:
544 South HWY 27
Minneola, FL 34715
Thursday, August 30th 3:30 pm-5:30 pm

For more information: Call: 352-343-1606 or E-mail: TCDTwirlers@aol.com

_________________________________________________________________________________
Please print and return:

Tri-City Dance Twirlers Registration Form
Please fill out completely and sign and date all forms.

Student’s Name: ______________________________________________
                             LAST NAME           /          FIRST NAME

Student’s Age: _____ Date of Birth:___/___/_____ Circle One:  M / F    T-shirt Size:_______

School/Practice location student will be attending __________________________________

Registering Adult:__________________________________  Relation: ________________

Address:__________________________________________ Cell Phone:_______________

City/State/Zip: __________________________________ Home Phone:_______________

Primary Email: _______________________________________________

Secondary Email: _____________________________________________

Emergency Contact: ___________________ Phone:(___)_______ Relation: ____________

All students must have their own health/accident insurance. It is advisable to consult
your doctor or health care professional before beginning any baton twirling or exercise
type activities.

ASSUMPTION OF RISK – RELEASE – INDEMNITY AGREEMENT
In consideration of your accepting this registration, I hereby release the Tri-City Dance Twirlers, (“TCDT”), and/or Evelyn Pelton from all liability for personal injury or illness while enrolled at TCDT. I understand that baton twirling may cause injury and I certify that my child is in good health and is capable of participating in the enrolled classes.

Tri-City Dance Twirlers has my permission to use photos of my minor child taken at the studio and competition in print form and/or electronically, including on the Tri-City website.

Signature of Parent/Guardian: _________________________________ Date:___/__/____

Office use only:
Reg. Fee: $_________Baton: $________Baton Size:______ Type of Pay:___________

Costume 1: $_______ Costume 2: $________   Shoe Size: ________   Shoes $______
Earrings: Clip/Pierce

Costume Measurements: B_______W_______ H _______   G_______      I________
                                                                                    Costume Size: ____________

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