2022 Summer Intensive Registration

The 2022 Senior Intensive is $375 and $110 for our Junior Intensive. For DAILY and CLASS rates, please email angel@coyb.org. Check your email for your invoice 48 hours after you register. Give us a call at 740-366-0030 or email info@coyb.org with any questions.

Dancer Name

First Name

Last Name

Intensive Selection

Please select which session you will attend.

Age

Please enter the dancer's age on August 3.

Dancer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Dancer Phone #

(if applicable)

(###)

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Dancer Email

Parent/Guardian

First Name

Last Name

Parent/Guardian

First Name

Last Name

Parent/Guardian Phone

(###)

###

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Parent/Guardian Email

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

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Medical/Surgical History

Please list any pertinent medical or surgical history that may impact your dancer's physical being, movement, and emotional presence during the intensive. Please list any medications - inhalers, EpiPen, insulin, allergies, etc.

Current Dance School