Dance Team Registration

Please fill out the registration form and a Representative will contact you.

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Name

First

Last

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Age

Address

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone

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Emergency Contact

Emergency Contact Name

First

Last

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Emergency Contact Phone

Relationship

Please Upload a Photo of Yourself

Click or drag a file to this area to upload.

Dance Experience History

Please describe your dance history. How many years have you danced?

HARRISBURG STAMPEDE

ARENA ADDRESS
Harrisburg Stampede
2300 N. Cameron Street
Harrisburg, PA 17110

TEAM ADDRESS
Harrisburg Stampede
234 State Street
Suite #103
Harrisburg, PA 17101
1-855-HBG-HERD
info@hbgstampede.com