Please register each attendee individually so we can cater the event to our special guest of honor!
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email: (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)*
Students entered below will be added to your family's account
Name of special guest*
Any known food allergies?
Favorite Disney character?
Is our special guest a boy or girl?
Have this special guest attended our tea before and if so, did they have a favorite activity?
Additional Information:
Photo Release
In conduction with my participant I give permission for Step N' Time Dance Studio to take and use photos and/or video of me or my child without remuneration in connection with studio publications, website, social media, and advertising. I understand that for the safety of our dancers and their families names will not be published or posted publicly unless previously notified.
I've read the above and agree.
Medical Release
As the legal parent or guardian, I give permission to Step N' Time Dance Studio, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or conditions and/or declare the participant to be in good physical and mental health.
I've read the above and agree.
Release of Liability
As the legal parent or guardian, I release and hold harmless Step N' Time Dance Studio, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or in route to or from any said premises. I understand that appropriate physical contact is required during the instruction of dance, and I give permission for instructors to make appropriate physical contact with me or my child for such instruction.
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*