Dance Plus Emerald Park Registration Form 2022-2023

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Please fill out one form per dancer. Do not combine dancers on the same form.

Email *

Dancer Name *

Birthdate *

YYYY

Parent's Names *

Phone Number *

Home Address *

Classes registering for *

Preschool

Combo

Mini Jazz (This is a jazz add on for our 5 year olds only who are also in the Combo class)

Tap

Jazz

Ballet

Lyrical

Hip Hop

Contemporary

Acro

Conditioning

Tap Exam

Jazz Exam

Required

Release Of Responsibility. I the parent/guardian assume the responsibility should anything happen to my dancer during his or her participation with Dance Plus EP. I hereby release Dance Plus EP with respect to damage or injury that may occur by virtue of such participation. *

Yes I Agree

Required

Media Release. I, the parent/guardian understand Dance Plus EP will post photos on their Social Media Sites. Permission will be asked at the time if any photos should be used and/or reproduced of your child for use in promotional material such as advertisements, brochures, pamphlets and/or publications. Please note that no names will ever be used or posted. *

Yes I Agree

Required

A copy of your responses will be emailed to the address you provided.

Submit

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