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A Day of Dance with the PCMS Blue Diamonds

 

WHO:                                     Elementary Students (PreK – 5th Grade)

 

WHEN:                                   Saturday, September 28, 2019 from 9:00am until 1:00pm

                                                Registration begins at 8:45am.          

 

PERFORMANCE:                 Dancers will perform at 1:00pm in the PCMS Gymnasium

 

REGISTRATION FEE:         $30 per child (Late Registration: $35 per child after Friday, September 20th)

 

Registration forms and fee must be received no later than Friday, September 20th to guarantee t-shirt.

 

Forms and money may be mailed to the following address:              PCMS BLUE DIAMONDS

                                                                                                            Attn: Ambie Watson

                                                                                                            5216 County Farm Road

                                                                                                            Blackshear, GA 31516

 

            *Forms and money may also be turned in to the front office at PCMS, PES, BES, and MES.

 

Lunch (pizza, chips, and kool-aid) will be provided for all participants.

 

Please contact Ambie Watson (ambiewatson@pierce.k12.ga.us) at (912)449-2077 with any questions or concerns.

 

Referred by (Blue Diamond Dancer):                                                                                                                   

 

 

Participant’s Name:                                                                                        Grade:                                   

 

Birthday:                      T-Shirt Size (circle one):   YXS      YS       YM       YL      AS     AM     AL    AXL

                                                                                  (2-4)       (6-8)      (10-12)    (14-16)

 

Address:                                                                                              City:                                                   

 

Mother’s Name:                                                                                  Phone #:                                            

 

Father’s Name:                                                                                   Phone #:                                            

 

Emergency Contact:                                                                           Phone #:                                            

 

Doctor:                                                                                                Phone #:                                            

 

 

Parent Agreement:  I understand that by signing my child up for this camp they will be participating in physical activity. I accept responsibility for my child under these conditions and agree to not hold the Blue Diamonds instructors and/or Pierce County Middle School liable for any injury that could occur.

 

 

OFFICE USE ONLY:

 

Date Received:                                                              Payment:                                                                  





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