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Cor Jesu Academy

Dance Team Clinic & Tryout Registration


Student Namerequired
First Name
Last Name
Parent Namerequired
First Name
Last Name

Medical and Emergency Releases

Must be completed for ALL participants.

By completing the following forms, I agree and understand that although Cor Jesu Academy has taken precautions to provide proper use and supervision for the Summer Camps at Cor Jesu Academy, it is impossible to guarantee absolute safety. Also, I understand that I share the responsibility for the safety of my child/myself during the activity and assume that responsibility. Further, I hold Cor Jesu Academy harmless and waive any claim which may arise against Cor Jesu Academy and/or its employees, agents and administrators.  


My child, whom I have registered above, is covered by:

Emergency Contact Namerequired
First Name
Last Name

Payment Information

Provide an email address for the receipt.

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