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Dance for Kids- ages 7-14- YWCA Southwestern IL
Event Timing: Thursdays September 15 -November 17, 6:00-7:00pm
Event Address: 304 E. Third Street Alton, IL 62002
Contact us at (618) 465-7774 or programs@ywcaswil.org
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Name of child participating in dance class *
Child's Date of Birth *
Contact Email *
Contact Phone Number *
Emergency Contact Information: Name *
Emergency Contact Information: Telephone Number *
For sliding scale fees, demographic purposes, and grant reporting, please enter your annual household income *
Please enter your household size *
For demographic purposes and grant reporting, please identify the race/ethnicity of the participant. *
For demographic purposes and grant reporting, please check any forms of Public Assistance that your household receives. *
I understand that I will have to sign a liability waiver and release for the minor participant before the first class. *
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