Coralyn J. Dance Class Registration

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Please complete the form below to register for upcoming classes. All participants must complete the form prior to attending class. Waivers must be signed prior to attending a class.

I understand that I am signing up for a "CONTEMPORARY DANCE CLASS with Coralyn J."

Yes

First Name *

Last Name *

Phone Number *

Gender *

Female

Male

Non-Binary

Other:

Is this your first dance class? *

Yes

Waiver *

I fully release Coralyn Jones, it’s instructors, independent contractors, and all other associates from liability for harm, theft, or injury that me suffered by me and/or members of my family traveling to or from or participation in activities and programs sponsored by Coralyn Jones. I hereby acknowledge that I am voluntarily assuming full responsibility for all risks of physical injury arising out of active participation in a dance class or other dance related activities. I understand that there are no refunds for registration fees. Please type the statement "I fully understand the waiver and agree to all statements"

I give permission to Coralyn Jones to use pictures and or video of my child for advertising purposes in print, promotional videos and on the website. *

Yes

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