Traveler´s Information

Name of Traveler *

Name of Traveler

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address *

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Gender *

Traveler is a *

T-Shirt size (only for dancers)

Date of Birth *

Date of Birth

YYYY

Passport Number and Expiration Date

Traveler is Allergic To

Traveler Medication

Traveler Special Diet

Room Preferences *

A one-time additional charge of $250 per single or triple room applies.

Please list all family members who are traveling with Young!Tanzsommer

Parent´s Information

Mother´s Name

First Name

Last Name

Mother´s Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mother´s Home Phone

(###)

###

####

Mother´s Cell Phone

(###)

###

####

Mother´s Work Phone

(###)

###

####

Father´s Name

First Name

Last Name

Father´s Address if different

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Father´s Home Phone if different

(###)

###

####

Father´s Cell Phone

(###)

###

####

Father´s Work Phone

(###)

###

####

Emergency Contact other than Physician or Parents

Name

First Name

Last Name

Home Phone

(###)

###

####

Work Phone

(###)

###

####

Cell Phone

(###)

###

####

Physician Name

First Name

Last Name

Physician Phone

(###)

###

####

Terms and Conditions

Medical Release (see print version below)

I have read and agree to the Medical Release *

General Terms (see print version below)

I have read and agree to the General Terms *

Payments (see print version below)

I have read and agreed to the Payment terms *

Please find the following information as pdfs:

Medical Release

General Terms and Information

Registration Intempo Dance Ensemble

Please find the following information as pdfs: