Parent & Tot & Tiny Ballerina Registration Form

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Please fill out this form if you would like to register for the Parent & Tot or Tiny Ballerina Class

Dancers Full Name *

Parents Name *

Phone Number *

Email Address *

Dancers Birthdate *

YYYY

Class Registering For *

Parent & Tot (Ages 18months - 2.5)

Tiny Ballerinas (2.5-5)

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

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

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