Registration
Already a customer? Click here to login.
Come see what MCDA is all about in this free day of mini classes! Come for one style or try them all out! All ages and levels welcome! Grab a sweet treat from the MooMobile in the parking lot from 12:30-2! 12-12:30pm Creative Movement ages 3-5; 12:30-1pm Tap ages 6-18; 1-1:30pm Contemporary ages 6-18; 1:30-2pm Jazz ages 6-18; 2-2:30pm Hip Hop ages 6-18; 2:30-3pm Family Bollywood ages 6+ Visit the Sweet Cow MooMobile in our parking lot from 12:30-2pm for a sweet treat!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Primary Doctor:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Primary Doctor:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Primary Doctor:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Primary Doctor:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Primary Doctor:
*
Questions/Options:
Which styles are you interested in participating in?
*
Additional Information:
Covid Assumption of Risk
(Show-Hide Details)
I understand COVID has a long incubation period during which a person may be a carrier of the disease but show no symptoms. I understand it is impossible to determine who has or does not have COVID, given the current limitations and availability of COVID testing. I understand because COVID is an airborne disease, there is a risk of contracting it simply by entering the premises of Mountain Kids Louisville, LLC. On behalf of myself and the minor children and others in my party, I voluntarily assume the substantial and significant risk of serious harm that may be associated with entering and using the premises and with attending and participating in activities at Mountain Kids Louisville, LLC. I agree to accept sole responsibility for any illness, injury, or expense of any kind that may result and to hold Mountain Kids Louisville, LLC harmless from any claim, expense, or liability arising from the same.
I've read the above and agree.
Participant Agreement
(Show-Hide Details)
I, the Responsible Adult, agree that the child(ren) named above may participate in any of the sporting, recreational, virtual (live & on demand) and other physical activities and programs of Mountain Kids Louisville, LLC (the organization). I understand that participating in such activities, including group activities with other persons, may be risky even under the best of conditions. I understand that participating in all such activities, including but not limited to gymnastics, dance, tumbling, trampoline, swimming, cheerleading, acrobatics, and parent-shared gymnastics, and using gymnastics and other sports equipment, could result in potentially severe injuries or illness to me or the child and damage to equipment and other personal property belonging to me or the child.
I've read the above and agree.
Representation of Ability to Participate
(Show-Hide Details)
I understand the nature of the activity, and I represent the student is qualified, in good health and in proper physical condition to participate in the activity. Should I ever believe any of the above representations have become untrue, or if I should ever believe the activity is not safe or is no longer safe for the student, then it will be my responsibility immediately to discontinue the student's participation in the activity.
I've read the above and agree.
Release for Medical Treatment
(Show-Hide Details)
In case of illness or emergency, as parent/legal guardian, I authorize Mountain Kids Louisville, LLC faculty to provide care or secure the services of a doctor if necessary. I hereby hold harmless the Mountain Kids Louisville, LLC staff and all involved with Mountain Kids Louisville, LLC programs from liability for any accidents resulting from participation and consent to Mountain Kids Louisville, LLC to secure emergency care as needed or prescribed for my child, at my expense. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my child. I also give permission to Mountain Kids Louisville, LLC to provide transportation as needed for my child in the case of an emergency at my expense. I understand that it is my responsibility to inform Mountain Kids Louisville, LLC of any changes to my child’s health. I understand that medical information and personal data will be used only in the Mountain Kids Louisville, LLC programs, when necessary, to protect a child’s well being.
I've read the above and agree.
Release Regarding Personal Injury and Property Damage
(Show-Hide Details)
I agree, on behalf of myself and the child, to assume all risks in connection with the activities described above. I release the organization and those acting on its behalf from liability for any injury or illness incurred by me or the child and for any damage to any equipment or other personal property belonging to me or the child. I agree to indemnify and hold harmless the organization and its officers, employees, and other representatives from any and all claims, demands, causes of action and to reimburse the organization and its officers, employees, and other representatives for any expenses, including attorney fees and court costs, that they may incur in connection with any injury or illness to me or the child or any damage to equipment or other personal property, however caused. I certify that I have obtained adequate insurance to cover any such injury, illness, or damage, or else I agree to bear the costs of such injury, illness, or damage myself.
I've read the above and agree.
Photo and Video Release
(Show-Hide Details)
I, on behalf of myself and the child, agree that the organization and its representatives may take and use pictures, videos, and other images of me or the child during any of the organization's activities and programs. I understand that the organization reserves the right to use and publish the pictures, videos, and images in any fashion for the organization's promotional purposes on brochures, print media, wall hangings, web sites, and other media and that the organization will not pay compensation to me or to the child for the use of the pictures, videos, and images. I acknowledge that I have read this entire document, that I understand and agree with each statement in it, and that I am signing it voluntarily and with full knowledge of its contents.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Please Wait...
