Our Mission
Here at Center
Stage we believe
that every child is
an individual. Our
focus is to bring that
individualism out
with freedom of
expression and
creativity. Our
mission is to pass
on our passion for
life through our love
for the art of dance
to the students of
Center Stage.
2008 Summer Dance Camp Registration Form
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Center Stage Dance Academy
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116 Long Pond Road
Plymouth, MA 02360
116 State Road
Sagamore Beach,
MA 02562
© CSDA 2007.
All rights reserved.
Parent(s) Name(s) _______________________________________________
Mailing Address _________________________________________________
City _________________________ State ________ Zip ______________
Home Phone ( ) __________________ Cell ( ) _________________
Age _______ Birth Date _____ / ______ / ______
Allergies or Medications __________________________________________
Emergency Name ____________________ Relationship _______________
Address _____________________________ Phone ( ) ___________
Liability Disclaimer:
Dancing is a physical activity so injuries may occur. Center Stage Dance
Academy and its instructors are not liable for personal injuries. Every student is
responsible for informing the instructor of any physical limitations which may
prevent the student's full participation in the dance instruction.
I hereby agree that I read and understand the above information (disclaimer and
contract).
Parent Signature _____________________________ Date _____________
Please Check Appropriate Camp:
Camp 1 __ Ages 6 - 10 yrs. 5 days, 9:00 - 3:00pm, Mon. July 21st - Fri.
July 25th $300.00
Camp 2 __ Ages 11 - 15 yrs. 5 days, 9:00 - 3:00pm, Mon. July 28th - Fri.
Aug. 1st $300.00
Family Discounts are available! Refer a friend and receive a free gift.
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Please make payment in full to register for summer dance camp. Registration
will be accepted on a first come, first serve basis. Refrigeration is available for
lunches brought from home. All classes will be held at the Sagamore studio
located at 116 State Road.
Mail Registration to:
Tiffany Prout
Center Stage Dance Academy
116 Long Pond Road, Box 16
Plymouth, MA 02360
508-888-2640 (phone)


