Registration
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Our free Musical Theater class gives prospective students the opportunity to participate in a class and learn about all our offerings in a fun and supportive environment. Musical Theater is a dance class focused on choreography from Broadway musicals and integrates many styles of jazz as well as acting. Recommended for dancers and performers at Beginning/Intermediate level, No dance experience required.
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
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Family Information
First Name:
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Last Name:
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Relationship
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Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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CA
CO
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DC
DE
FL
GA
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ME
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Zip:
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Emergency Contact Info (Not Contact #1 or #2)
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Add New Student #1:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Student Email:
School:
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Grade Level:
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preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
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college
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college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Primary Doctor:
*
Tight size:
*
Shirt size:
*
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Primary Doctor:
*
Tight size:
*
Shirt size:
*
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Primary Doctor:
*
Tight size:
*
Shirt size:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Primary Doctor:
*
Tight size:
*
Shirt size:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
School:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Primary Doctor:
*
Tight size:
*
Shirt size:
*
Additional Information:
Release of Liability
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I hereby consent to the aforementioned person participating in The Dancing Center Unlimited class. I recognize that potentially an injury can occur in sports activities involving motion. Those activities including, but not limited to, dance. I hereby give my consent for my child to participate in any and all of The Dancing Center Unlimited programs and activities and I ACCEPT ALL RISKS associated with this participation. If necessary, I hereby agree to individually provide for all medical expenses which may be incurred by me or my child as a result of any injury sustained while participating at or for The Dancing Center Unlimited.
I have read and understand this ASSUMPTION OF RISK and WAIVER OF LIABILITY and MEDICAL AUTHORIZATION and I voluntarily affix my signature in agreement.
I've read the above and agree.
Video and Photo Waiver
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I give The Dancing Center Unlmited. my permission for the public display of pictures and or video of my child for possible advertisement purposes (i.e. brochures, newspaper ads, web site, etc. - no names will be used).
I've read the above and agree.
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