Seymour Dance OPEN HOUSE WEEK - Sign Up & Waiver Form
Join us for a fun and exciting week of dancing! Try a free class and meet our staff!
Google にログインすると作業内容を保存できます。詳細
Student FIRST NAME: *
Student LAST NAME:
Student Age: *
Are you...
Parent/Guardian Name: *
Parent Phone #: *
Parent Email Address: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
I consent to my child’s participation in a dance class. I am aware that there are risks associated with participation in the class, including the risk of injury, and I consent my child’s participation in spite of such risks. In the event that my child requires medical attention, I consent to my child being transported to the nearest emergency centre, including by ambulance if necessary, and accept that I am responsible for any costs of such ambulance service. *
必須
Class(es) You Are Attending: *
必須
How did you hear about us? *
必須
送信
フォームをクリア
Google フォームでパスワードを送信しないでください。
このコンテンツは Google が作成または承認したものではありません。 不正行為の報告 - 利用規約 - プライバシー ポリシー
Google フォーム