Star-Styled Dance Center
"
Where Every Dancer is a STAR"724-772-STAR 20455 Route 19 Excel Center Cranberry Twp., PA 16066 www.starstyleddance.com
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__________________________
Relationship
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.
_____________________________________________________ ________________________
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.