Registration And Waiver Form
Please fill out this form to register your child to become a Motivate By Dance Team Princess. Registration is $20 which includes a practice shirt.  Maximum Participants is 30. We will contact you if we have reached maximum capacity.
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Which team are you registering for? *
Email *
Participant Name *
Participant Birthday *
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Current age (Must be  at least 5yrs or older) *
INSTAGRAM BIRTHDAY SHOUT-OUT                                                                                                                                                                   **I give permission for my daughters birth month and picture to be displayed on Motivate By Dance's Instagram.  Only her first name will be given.  Her actual birth date will not be disclosed.  Pictures should be posted during the first week of the month. It is your responsibility to send in a picture of your child to be posted. *
Required
Parent or Guardian please type your name below stating you acknowledge and understand the birthday shout-out information. *
What is the name of the school your child attends? *
What is your T-Shirt Size?   *
Depending on the design, the participants first name may be printed on the left sleeve of the shirt at no extra charge.  Please type participants first name below.  It is okay to use a nickname. If you do not want a name on shirt please type: no name *
Parent or Guardian Name *
Best Contact number to be reached *
MOTIVATE BY DANCE, LLC ONLINE MEDIA/PHOTO/VIDEO/WAIVER FORM                                                                             I understand that the above participant may be included in pictures, videos, Facebook, Instagram or other communication forums generated by or to the public. I understand there is no compensation or royalties arising from or related to the use of their image. If the participant is no longer an active member and you wish to opt out of future Motivate By Dance, LLC Media/Video/Photo, please send a letter to motivatebydance@gmail.com   Attention: Opt Out of  Media/Video/Photo Waiver Form. Please be aware that any public postings before the timestamp of the opt-out email will not be removed. *
MOTIVATE BY DANCE, LLC WAIVER FORM                                                                I agree that the above named participant is in good health and can physically withstand the instruction led by Motivate By Dance, LLC. I hold harmless Motivate By Dance LLC, Coaches, and Volunteers from any injury of any kind that may result from participation of all activities which included meetings, functions or events. I understand that the above participant can be removed at any time due to improper behavior or dress code which includes disobeying rules of the organization or fighting. This waiver has no expiration date. *
Parent or Guardian Name: By typing your first and last name below, I am the legal parent or guardian. I agree to the Motivate By Dance, LLC Waiver Form and the Motivate By Dance, LLC Media/Video/Photo Waiver Form in its entirety.  This agreement has no expiration date. *
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