Registration
This camp will include a dance class, a craft and will conclude with fun dance games!
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
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
 
Questions/Options:
How did you hear about this event?*
What school does your child attend?*
 
Additional Information:
 
Liability Waiver
As the legal parent or guardian, I release and hold harmless Meaningful Movement Dance and Yoga, 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 of 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.
 
Photo and Social Media
In conjunction with my participation, I give permission for Meaningful Movement Dance and Yoga 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 I understand that for the safety of our dancers and their families names will not be published or posted publicly.


I've read the above and agree.
 
Payment
Classes without sufficient enrollment will be canceled and refunded.
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: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*