Summer Camp Registration Form

Select if you'd like to register for Half Day or Full Day
Full DayHalf Day

Weeks (Please choose what weeks your child will be attending)
Week 1 - 6/11Week 2 - 6/18Week 3 - 6/25Week 4 - 7/2Week 5 - 7/9Week 6 - 7/16Week 7 - 7/23Week 8 - 7/30

Payment Method
In order to receive the discounted rate of our 4 week and 8 week sessions, please choose one of the following payment options (please note your credit card will be charged the full nonrefundable payment once registered). If you are paying the weekly price, you will only be charged the one week of $159.00 for full day and $110.00 for half day. This one week deposit fee will be applied to the week/weeks your daughter chooses to attend the summer dance camp. This is a non-refundable deposit. Weekly payments must be made at the front desk on Monday mornings by check or credit card.

***Online Registration- Your Credit Card will be charged once you have registered online. Please provide a credit card number in order to reserve your child’s space. Spaces are limited.***


** Register by May 26th to reserve your spot and receive a free summer camp T-shirt**

Full Day / Half Day Prices: (please check payment option)

Half Day - $110 per weekHalf Day - 4 weeks $105 per week(paid in full by May 26th)/total = $420Half Day - 8 weeks $100 per week (paid in full by May 26th)/ total=$800Full Day - 1 Week = $159 per weekFull Day - 4 weeks =$149 per week (paid in full by May 26th)=total $596Full Day - 8 weeks= $139 per week (paid in full by May 26th)=$1,112 per student

No Refunds. Please insert your Parent Initials below (We accept credit cards and checks only. ** No cash)

Emergency Contact Information

The following people should be contacted in case of emergency, only if parents or guardian cannot be reached AND are authorized to pick up their child.

IS THE CHILD TAKING ANY MEDICATIONS?
YesNo

Disclaimer: Any students participating in the MDM Dance camp takes certain incumbent risks.
These include but are not limited to pulled muscles, strains, and broken bones. Participation in class and/or events indicated the acceptance of risks by attendees and their parents and/or guardians. Miami Dance and Music Academy assumes no responsibility for personal injury or property loss at the dance studios or any of the events.

MDM Academy