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Register NOW for
our TRY IT OUT camp!
Syracuse, Fayetteville, Watertown and Binghamton
LOCATION: Johnston’s Bally Bay, 550 Richmond Ave, Syracuse, NY
DATE: July 14 -16, 2015 10:00 a.m. – 11:30 a.m.
DANCE CAMP FEE: $75.00 (includes a t-shirt)
TO REGISTER: Please make checks payable to Ann Sullivan and mail the bottom Registration
form along with your check to:
Johnston’s Summer Dance Camp:
C/O Patty Wilsch; 212 Lathrop Rd, Syracuse NY 13219
Questions: Please e-mail Patty Wilsch at pewilsch@hotmail.com
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Student name:___________________________________________________ Age______________
Parent name:_________________________________________________
Phone #_________________________
Address:_______________________________________________________________________________________
Any allergies or medical issues that we need to be aware of? ______Yes _______ No
Please explain:__________________________________________________________________________________
______________________________________________________________________________________________
In case of emergency, whom should we contact:____________________________________ Phone #________________
T-Shirt size: Youth S M L
Adult S M L