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Star-Styled Dance Center

"Where Every Dancer is a STAR"

724-772-STAR                                                                20455 Route 19 Excel Center Cranberry Twp., PA 16066           

Shining Stars Day Camp Registration – SUMMER 2009

Child’s Name ___________________________________________________________ Age _______________

Little Stars (3-5 y.o.)  June 15-19    9:30am -12:00 noon M-F      Shining Stars (6-9 y.o.)  June 22-26    9am-3pm M-F
                              July  6-10     9:30am-12:00 noon M-F                                          July 13-17      9am-3pm M-F 
Aug 3-7    9:30am-12:00 noon M-F

                                     Super Stars (9 and up)  August 3-7     9am-3pm M-F


Parent Name(s) ______________________________________Email for enrollment confirmation_________________________

Address __________________________________________________________________________________

Home Phone___________________________________ Emergency Phone _____________________________

Contact Person in the event that neither of the above numbers is successful:

Name_____________________________________(_______________) Phone__________________________

Please list any medical concerns/conditions of which we should be aware (please include allergies):



I give permission for my child (named on the top of this form) to participate in camp activities during the Shining Stars Day Camp. I understand, as with any physical activity, that there is a risk of injury during participation in this camp. I hereby release Star-Styled Dance Center, Cheryl K. O’Malley, Megan Kohler, and other camp staff from all liability should my child be injured.


_____________________________________________________                                        ________________________
Parent Signature                                                                                                                                               Date

Please Check One:    Full Day (9am-3pm) Star-Styled Dance Student           _____  Fee: $140

                                    Full Day (9am-3pm) Non-Star-Styled Student              _____ Fee:  $160

                                    Half Day (9:30am-noon) Star-Styled Dance Student      _____  Fee:  $80

                                   Half Day (9:30am-noon) Non-Star-Styled                      _____  Fee: $90


Payment due upon registration.  Make checks payable to camp instructor:  Megan Kohler. Registrations may be left at studio desk or mailed to: Star-Styled Dance Center attn: Summer Camp 20455 Perry Highway, Excel Center, Cranberry Twp., PA 16066.  Registration per week will be limited.  Register early for highest availability.  We reserve the right to cancel a camp week due to insufficient enrollment.  In such cases, full tuition will be refunded.  There are no refunds for student cancellations or missed days during camp week.