2024 TU LEFT FEET MINI SESSION

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

*1 Student per enrollment form.

*A copy will be immediately sent to the email provided - this is your confirmation.

*Classes begin the week of April 8, 2024 and run through the end of May. (8 Weeks of Class)

*$200 Tuition will be drafted from the card provided on this form.

*Class sizes are limited and are filled on a first come, first serve basis. Class times are subject to change if there are less than 4 students enrolled in that class.

Email *

Primary Email Address *

important updates, information, newsletters and closings will be sent to this address.

Please select the class you would like to register for: *

Student's 1st Name *

Student's Last Name *

Student's Date of Birth *

Student's Age *

Student's Current Grade Level *

Parent or Guardian Cell Phone *

(Emergency Contact)

Parent or Guardian's Name *

(Emergency Contact)

Alternate Phone *

what number do we contact if we can not reach the emergency contact listed above?

Secondary Parent or Guardian's Name *

who do we contact if we can not reach the emergency contact listed above?

Allergies, Previous Injuries, Illnesses, etc.

Release of Claims and Treatment Authorization *

I am aware that dance, acrobatic arts, gymnastics and any physical exercise associated with it, place unusual stress on the body and carry with them the risk of physical injury. On behalf of my child and/or myself, I assume this risk and agree that Tu Left Feet, LLC and its staff shall not be liable in anyway for the injuries sustained during attendance at the studio, located at 13110 Midlothian Turnpike, Midlothian, VA 23113 or any of its away functions. I grant my child/myself permission to participate in the 2024 season; and I release and discharge any claims, demands, actions, judgments, and executions to which the students, heirs, executors, administrators or assigns may have, or may claim to have against Tu Left Feet, LLC, its successors, its assigns for all personal injuries caused by, or from the above activities or any activities related. Further, I grant, Tu Left Feet, LLC and its employees permission to authorize any emergency medical treatment that may be required during participation.

Yes, I agree to and understand the above statement.

Photography Release *

I, the parent/guardian (or student, if 18+) authorize Tu Left Feet, LLC and/or its representatives, agents, or staff to use any photographs of my child (or myself), for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by the artistic staff or marketing director.

Yes, I agree to and understand the above statement.

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms