Registration
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Join us for a fun-filled sneak peek into our program! You'll get to tour the studio, meet the fabulous Miss Paige, and see an exciting preview of what's to come. It's the perfect way to get a taste of the magic before the session officially begins! 4-6 year old dancers, Saturday March 15th at 11:00 am 7-10 year old dancers, Friday March 14th at 5:30 -6:00 11 + year old dancers, Friday March 14th at 6:30 -7:00 Parents we will be there before and after each FREE class to answer questions and help you sign up for our next session. Sign up today!
Event:
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Fee per Family:
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Family Information
First Name:
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Last Name:
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Home Phone:
Cell #:
Work #:
Email:
(Emails are kept confidential)
Address:
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City:
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State:
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Emergency Contact Info (Not Contact #1 or #2)
Add New Student #1:
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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
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School:
Allergies (Leave blank if NONE):
Add New Student #2:
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Student's First Name:
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Last Name:
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Student Gender:
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Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School:
Allergies (Leave blank if NONE):
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Allergies (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Allergies (Leave blank if NONE):
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
Allergies (Leave blank if NONE):
Questions/Options:
Dancer's name
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Additional Information:
Assumption of Risk
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I, the parent or guardian of the below named minor child (the “Participant”), who desires to participate in dance classes and performances offered and organized by Gotta Dance Company (the “Studio”), hereby acknowledge that I am aware that there are significant risks associated with participation in such dance classes and performances, including, without limitation, the risk of serious bodily injury. On behalf of myself, my spouse and the Participant, and our respective heirs, administrators, representatives and successors, I willingly assume such risks. Further, I hereby represent that Participant has no physical or mental disability or impairment or any illness that will endanger Participant or others in connection with Participant’s participation in the dance classes and performances offered by the Studio.
I've read the above and agree.
Release of Liability
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I, the parent or guardian of the Participant, for myself, my spouse and the Participant and our respective heirs, administrators, representatives and successors, hereby waive the right to bring any claim or suit and hereby voluntarily release and discharge the Studio, its owner (Trish Madden), employees, independent contractors, agents and insurers from any and all claims, demands, causes of action, liabilities, damages, costs or expenses (referred to herein collectively as “Claims or Losses”) arising out of, relating to or in any way connected with Participant’s participation in the Studio’s dance classes and performances, including, without limitation, any Claims or Losses for personal injury, wrongful death or property damage allegedly arising out of the negligent acts or omissions of the Studio’s owner(s), employees, independent contractors or other agents.
I've read the above and agree.
Medical Emergencies
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I, the parent or guardian of the Participant, hereby authorize the Studio and its owners, employees, independent contractors and other agents to consent to and authorize the emergency medical treatment of the below named Participant by a physician duly licensed or by a dentist duly licensed in the state of Arizona. I understand that this Consent to Emergency Medical and Dental Treatment will be used by the Studio only if it is unable to reach me within a reasonable period of time given the circumstances of the emergency. On behalf of myself, my spouse and Participant, I forever release the Studio and its owners, employees, independent contractors and other agents from any and all liability related to the exercise of the authorization provided herein.
I've read the above and agree.
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