ZDDA Holiday Dance & Prance Registration Form
Please complete the registration form below once for each dancer attending classes during the event.
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Dancer's Name *
Dancer's Current Age *
ZDDA Referral (if applicable)
Enter the first and last name of the ZDDA student who referred you.
Dancer's Class Placement *
Parent's Name *
Parent's Phone Number *
Desired Format:   XXX-XXX-XXXX
Parent's Email Address *
Emergency Contact Name & Relation *
Emergency Contact Phone Number *
Desired Format:   XXX-XXX-XXXX
Waiver: I hereby authorize the staff of ZD Dance Academy and its associates to act on my behalf according to their best judgement in any emergency situation requiring medical attention and I hereby waive and release ZD Dance Academy and its associates from any and all liability for any injuries or illness incurred while attending classes at the studio or on the studio premises. In addition, permission is granted for my child to be photographed/video recorded on ZD Dance Academy Premises. Permission is also granted for any of the photographs or videos taken to be used in marketing materials to promote ZD Dance Academy. *
Required
An inherent risk of exposure to Covid-19 exists in any public place where people are present. I acknowledge the contagious nature of Covid-19 and voluntarily assume the risk that myself or my child may be exposed to or infected with Covid-19 by mere presence within this establishment and that such exposure may result in personal injury, illness, or even death. I understand that the risk of becoming exposed to or infected with Covid-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, program participants, and their families. I hereby release ZD Dance Academy from any and all liability from claims arising from or in connection with any direct Covid-19 Impact. *
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