New World Dance - Adult Registration
Welcome to New World Dance! Let's get a little information first...
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Date of Birth
MM
/
DD
/
YYYY
Age
Prior dance experience (if applicable - we welcome beginners!)
Email *
Address *
Cell phone number *
Additional Phone Number (optional)
What type of dance class(es) are you interested in?
Do you have any medical conditions we should be aware of?
Emergency Contact Information
Please provide the information for someone we can contact in the case of an emergency
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact Phone #
Relationship to dancer
Liability Release and Waiver - I understand that dance training requires sustained, repetitive, vigorous physical activity, usually performed on a hard or lightly padded surface. It is also understood that dance instruction involves kinetic corrections that may include physically touching the student as part of regular class work and rehearsals. I understand that there are inherent risk of personal injury and illness arising from my attendance and participation in such activities and events. I hereby agree to release New World Ballet, it's Board of Directors, instructors and agents from all personal injuries, illness or property damage resulting from my attendance and participation in such activities and events. *
Required
Photo Release - may we take photos and video for the purpose of promoting the school? *
Required
Thank you for submitting your registration form! We look forward to meeting you.
We will call you within 48 hours to answer any questions and set up your first class. You may also call us at 510-332-5250.
You can view the class schedule and pricing information at any time by visiting our website at www.newworldballet.com.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy