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Help us kick-off the Connectivity Kids Carnival and Join us for a Bike Parade down 51st Ave!! Bike judging by the Connectivity GuiiDance Team and The Grain Elevator Youth Counsel
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Family Information
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Last Name:
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School:
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Grade Level:
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10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
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college
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Student Email:
School:
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Grade Level:
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10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
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preschool
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Student's First Name:
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Last Name:
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Student Gender:
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Female
Male
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Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
homeschool
kindergarten
pre-K
preschool
university
Class Accommodations Needed (Leave blank if NONE):
Allergies (Leave blank if NONE):
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Additional Information:
Participation Waiver
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I give my approval for my child’s participation in this event.  I assume all potential ricks and hazards incidental to the activities.  In case of injury to my child, I hereby waive all claims against Connectivity Dance Ltd., the owner, instructors, employees and volunteer members as well as all parties sponsoring CDL, including but not limited to the City of Leduc and the Grain Elevator Heritage Society.  I release from responsibility any person transporting my child to and from the studio and the event, or in case of emergency to the doctor or hospital.
I've read the above and agree.
Helmet Acknowledgement
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I acknowledged that a bicycle helmet must be worn, regardless of age, in order to participate in the Connectivity Kids Carnival Canada Day Bike Parade
I've read the above and agree.
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