DANCE PAR-TAY REGISTRATION
!*!*!Calling all Swifties!*!*!

  Please complete this form to register for the party.  Please complete this form for each dancer in your family. 
Come join us for a night of dancing, games, contests, bracelet making, and food. 
Let's SHAKE IT OFF and have a great time!  

            SATURDAY, APRIL 13 6-8 pm
              (Doors open at 5:45pm)                        
            Please Drop off by 6:00pm and Pick up at 8:00 pm.
  • Cost: $15 - please pay cash or Venmo (include dancer(s) name (@STT08) or pay cash at the front desk. 
  • We will provide Pizza and beverages. 
  •  Parents, please note that some lyrics contain adult language. 
  • Dress like Taylor or wear your favorite ERA attire!  (Contest by age groups)  
  • Friends are welcome, everyone will need to complete this form. 
  • no high heels, please
  • Space is limited!  Register now! 
LOCATION: Special Touch Talent Dance Studio - 3120 Woodman Dr, Dayton OH

email: missmelody@specialtouchtalentdance.com for any questions. 


We can wait to SHAKE IT OFF with all of our Swiftie friends!  



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PARENT NAME:  *
PARENT EMAIL:  *
PARENT CELL PHONE:  *
Swiftie's (participant) name: 

 *
AGE:  *
ANY MEDICAL ISSUE WE NEED TO BE AWARE OF FOR THIS EVENT:  LEAVE BLANK IF NONE
Dear Parent(s),
We will be taking photos an videos to post to our social media accounts. Please mark this to let us know if we have your permission to include your dancer in photos or videos.

There are some songs that will be played that may have PG-13 language, I undertand that some songs played will have this language in the song.

PLEASE CHECK THE CORRECT BOXES BELOW: 
 *
Required
RELEASE OF LIABILITY SECTION
I/we realize that participation in this dance classes, events, and activities could involve some possible personal injury.  Despite precautions, accidents and injuries may occur.  By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by Melody K. Durnbaugh D.B.A. Special Touch Talent Dance.  

I/we agree to release and hold harmless Melody K. Durnbaugh D.B.A. Special Touch Talent Dance, including its teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future.  I/we will not hold Melody K. Durnbaugh D.B.A. Special Touch Talent Dance liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes.  Furthermore, I/we agree to obey the class/event and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Melody K. Durnbaugh D.B.A. Special Touch Talent Dance.  

I understand that Melody K. Durnbaugh D.B.A. Special Touch Talent Dance is an insured organizations.  In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes or event, I/we agree to report the unsafe conduct or conditions to the Studio Director, instructor or staff member as soon as possible.
 *
Dear Parent, Are  you interested in volunteering for the event?  If so, you will be contacted.  *
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