Circle which week/weeks you are inter-ested in

June 30th - July 3rd August 4th-7th

August 18th- 21st9am-10:30am 11am-12:30pm

Ages: 2-4 Ages: 5-8

Tuition: $85.00 a week

Name:__________________________________________________

D.O.B.____________ Age:_____________ Grade in

Sept.______________

Names of Parent/Guardian:_____________________________________

Address:__________________________________________________________

City:_____________________ State:______________

Zip:_____________

Parent’s cell: ____________________________________________________

Parent’s Cell: ____________________________________________________

Email:____________________________________________________________

please fill out registration form and return with full Payment to:

Prince/PRINCESS Dance Camp!

Dance Xhilaration, LLC 451 Main Street Stoneham, MA 02180