Emergency Contact — Ballet of York County

Emergency Contact Form

Please fill out the form so that we can have emergency contact information for each dancer on file, especially for the performances.

Dancer's Name

First Name

Last Name

Parent's Name

First Name

Last Name

Parent Cell Phone

(###)

###

####

Emergency Contact Name

First Name

Last Name

Emergency Contact Number

(###)

###

####

Who will be authorized to pick up your child: