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Fee includes both days of workshop. Please remit payment of cash or check to: Tanya's Dance Company Attn: Ignite 81 8th Street, Suite 8 Belgrade, MT 59714. If you wish to pay by credit card there is a processing fee of $14. Your card will be charged $344 when you register.
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End Date/Time:
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Room:
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Family Information |
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Students entered below will be added to your family's account
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Additional Information: |
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Release of Liability
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As the participant, legal parent or guardian, I assume all of the risks of my child participating, and I release, agree to indemnify, and hold harmless TANYA’S DANCE CO., 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, including virtual dance classes, under the control and supervision of TANYA’S DANCE CO., its owners and operators or in route to or from any of said premises.
I've read the above and agree.
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Medical Emergency
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The undersigned gives permission to TANYA’S DANCE CO., 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 condition and/or declare the participant to be in good physical and mental health. I request that our doctor/physician as listed above be called and that my child be transported to the nearest hospital if deemed prudent by the staff.
I've read the above and agree.
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Photo Release
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I, the minor's parent and/or legal guardian, hereby grant permission to the studio to take photographs of my child. I fully understand that these photos may be used in brochures, websites, posters, advertisements, social media platforms and other promotional materials the studio creates. Permission is also hereby granted for the studio to copyright such photographs in its name. I understand if I do not agree to have my child be in photos, I have to notify the studio in writing.
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: |
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Name as it appears on card: |
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Nickname:
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Exp Year:
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Address Line 1:
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Address Line 2:
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Bank Routing Number: |
(9-digit number)
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Your Account Name: |
(Your name on your bank statement)
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Account Number:
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