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| REGISTRATION FORM
($30 Registration Fee Due @ Time of
Registration) |
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1st Dancer Info:
Name-
Birth Date- Age-
School- Grade-
Address-
City-
State- Zip-
Medical Conditions or Allergies- |
2nd
Dancer Info:
Name-
Birth Date- Age-
School- Grade-
Address-
City-
State- Zip-
Medical Conditions or Allergies- |
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Parent Name _______________________________ Phone #
_______________Cell # ____________
Address _________________________________________ City
___________ State _____ Zip ______
E-mail Address
_________________________________________________________
Emergency Contact _________________________________ Phone #
_______________
Cell #_____________
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SIGN ME UP FOR THE FOLLOWING ABSOLUTE DANCE CLASSES!
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Dancer: |
Class: |
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Dancer: |
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Dancer: |
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Dancer: |
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Dancer: |
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Permission to Participate and Photo/Video Release:
The undersigned as parent/guardian of the dancer(s) listed
above hereby give permission for my child/children to
voluntarily participate in
Absolute Dance,LLC. class,
activities, and events. I understand the inherent risk
associated with these activities and that all rules/policies
imposed upon the participant(s) must be followed in order to
reduce the risks or prevent injury. In consideration for the
advantages of my
child's/children's participation in the
activities described above, I, for myself, my spouse, my
heirs, and assigns, hereby release and hold
harmless the
Absolute Dance, LLC, its present and future individual members,
officers, agents, employees, directors, representatives and
insurers, from any and all liability, for bodily injury or
property damages that may result from my child's- children's
participation in the activities
described above except as
provided by law. I give permission for Absolute Dance! to use
photos and/or video of the participant(s) listed above
for
legal promotions. Furthermore, I agree to carry health
insurance on the participant(s) above for the duration of
their participation in the above
activities.
Insurance Company ______________________________________
Policy Number____________
Absolute Dance Studio Policies:
I have thoroughly read and understand the Absolute Dance
"Dancer & Family Handbook", and agree that my dancer(s),
family and guests will
abide by the policies set forth by
Absolute Dance for the duration of their participation in the
activities mentioned above.
Parent/Guardian Signature
______________________________________________ Date____________ |
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