Dance for Social Change (DSC) Youth Program Interest Form

Please complete this form to let us know which program(s) you are interested in registering for or learning more about.

This form is NOT the registration form, a representative of Dancing Grounds will be in contact with the correct registration form upon completion of this interest form.

Parent Information

First Name

Last Name

Cell Phone

When is the best time for us to call?

Other

Student Information

First Name

Last Name

Birthdate

Ex. 01/11/2000

Grade Level in upcoming School Year

Race/Ethnicity

Gender Identity

Anything else you want to let us know about your child's gender identity or race/ethnicity?

Program Information

What Programs are you interested in? *school year programs

DSC Tots (ages 3-6)*DSC Juniors- Team Flex (ages 7-9)*DSC Juniors- Team Pointe (Ages 11 - 12)*DSC Teen Company (8th-12th graders)*DSC Juniors Summer Camp (Ages 7-12 or rising 3rd- 7th graders)DSC Freedom School: Revolution Reimagined (rising 8th-12th graders)Youth Town Hall (all ages)