Registration
Come Join us and see what Theater Dance Center is all about. Ballet, Lyrical, Jazz and Tumbling! Comfortable clothing to move in and a clean pair of sneakers. NO FEE for this class
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*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Release of Liability
As the legal parent or guardian, I release and hold harmless Theater Dance Center, 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 any premises under the control and supervision of Theater Dance Center, its owners and operators or in route to or from any of said premises.
I've read the above and agree.
 
Photo Release
I hereby grant permission to Theater Dance Center to use my child's image on any promotions or advertisements.
(If you do not agree to any of the agreements please register in person at the studio)

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: