Name *

First Name

Last Name

Vaccination

Vaccination against COVID-19 is required for this event.

I am/will be fully vaccinated by the date of the event

I will be partially vaccinated by the date of the event

I am not vaccinated

Authorization *

I authorize Word Dance Theater to use any images of me from this event for future marketing or website use

I do not authorize Word Dance Theater to use images of me

How would you like to pay? *

Online (PayPal)

Check to Word Dance Theater

How did you find us? *

Friend

N/A (Returning student)

Neighborhood listserv

Online search

Other

To finish registration *

I understand that registration is not complete until payment is received. After clicking "SUBMIT" I will wait for the PayPal button to appear, then follow that link to online payment, or mail a check.