RSVP 1 — Vox Artium

2024 Vox Winter Clinic Registration

Sun, Dec 22 • 3pm-8pm • Rancho Buena Vista High School

Includes one dance class & one equipment class

Bring your own equipment

Upon form submission you will be redirected to pay the $45 clinic fee

Performer's Name

First Name

Last Name

Age

How many years of experience do you have?

High School Attended/Year of graduation

Where else have you marched?

I authorize Vox Artium to edit, copy, exhibit, distribute, and use any video or images taken of me during the Vox Winter Clinic

I agree

Pick ONE movement class

Pick ONE equipment class

Insurance Provider

Policy Number

Any physical or mental pre-existing conditions:

List any medications you are on

Emergency Contact Name

First Name

Last Name

Emergency Contact Relationship

Emergency Contact Phone

(###)

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I herby submit this information to the Vox Artium Foundation Inc and entrust them to use this information to the best of their ability in the case of an emergency regarding my wellbeing or the person for whom I am responsible in the event of an emergency all medical bills and/or charges incurred will be the responsibility of the individual members insurance or personal responsibility. Vox Artium & Mission Hills High School will not be held liable.

I Agree

If Under 18

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Phone

(###)

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