Darby's Dancers "Get to Know You" Form
We are so excited to have your dancer join our Bella Via family, and the Darby's Dancers Program. Make sure you are registered through the studio using the link provided on our website, social media or email before completing this form. After registration is complete, please complete this form with as much detail as possible. We will use this information to partner our Bella Buddies with your dancer and for our team to review as we prepare for your dancer. Let us know how we can make this a success for your child. We will do our best to include these elements in our coaching plans for your dancer.


We can't wait to dance with you!!!
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Dancer's Name (first and last... include a nickname if preferred) *
Parent's Name (first and last) *
email address *
What is your dancer's t-shirt size AND shoe size? (this will be for a unisex t-shirt... please specify if you are referring to a child or adult size) *
What is your child’s diagnosis? Please be specific so we can prepare for his/her needs. *
What would you like your coach assistant do to help your dancer:
Please check any of the following items that apply to your dancer:
Anything else that we need to be aware of? Please list below:
By agreeing to allow my child to participate in the Darby’s Dancers program, I, on behalf of myself and my family members, are hereby releasing the dance instructor, program coordinator, studio owner(s) and the Darby’s Dancers National Organization, along with it’s officers and directors from any and all liability for their actions in which I have not previously brought to their attention in writing. *
Required
Photo and Video Release: I authorize the program to use the following personal information for my family and dancer:  Pictures-including photo, motion, electronic images. Voices-including sound and video recordings. I grant the right to publish, reproduce for all purposes and copy my image as needed for the benefits of the organization. This includes but is not limited to print media and video recorded for the purpose of the program. 
I waive the rights for any compensation for the use of the photos, audio, media and for any of the finished photos, audio and video, advertising recording and copy- righted materials and also for anything generated by a computer. 
                                                         By typing my name below I am acknowledging that I am signing for my child and on behalf of my family members and I am granting permission for my child to participate in all aspects of Darby’s Dancers. *
Required
I am acknowledging that I am signing for my child and on behalf of my family members and I am granting permission for my child to participate in all aspects of Darby’s Dancers. *
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