TITANETTES ICE GIRLS

SKILLS CLINIC

Hosted by: Titanettes Ice Girls | CMXI•NEXT Productions

In partnership with: NJ Titans Hockey + Middletown Sports Complex

Event Location: Middletown Sports Complex

Upcoming Session Tuesday Dates:

March 17th - 6pm + 7 pm

March 24th - 6pm + 7pm

April 7th - 6pm + 7pm

April 14th - 6pm + 7pm

Lights, Camera, Action - APRIL 21st 6pm + 7pm

Youth Dance Experience | Registration & Liability Waiver

ACADEMY ARTIST INFORMATION

First name

Last name

Birthday

Month

Day

Year

Age

Grade

School Currently Attending:

Please Note: If the Academy Artist is under 18 years of age, all contact information must belong to a Parent or Legal Guardian. Academy Artists who are 18 years of age or older should provide their own contact information.

Phone

Which division are you interested in?

Rising Stars (4-6)

Next Generation (7-10)

Spotlight (11-14)

Professional Prep (15-18)

Previous dance experience?

YES

Tell us alittle about your Academy Artist

PARENT / LEGAL GUARDIAN INFORMATION

Parent/Guardian Full Name

Phone

EMERGENCY CONTACT INFORMATION

Emergency Contact Full Name

Emergency Contact Phone

Yes, I would like to receive updates, announcements, upcoming events, and enrollment information from CMXI NEXT.

PARENT / GUARDIAN SIGNATURE (if Academy Artist is under 18) OR Academy Artist Signature (if 18 years of age or older).

PRINTED NAME

Signature

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Date

Month

Day

Year

ACADEMY ARTIST INFORMATION

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