1 form per student.

Adult Students may skip.

Standard messaging rates pending your provider may apply in the event school notifications are sent via Text Message*

We will be sending your registration form to this email.

Our primary method of contact.

ie: Pleasanton, Dublin, San Ramon, Danville, Livermore, etc.

Name & Contact Number, different from contact above.

Please list any injuries or allergies that the Student may have that XPD teachers and staff should be aware of.

By signing your FULL NAME here, you are agreeing that you have carefully read the WAIVERS and agree to its contents. You are aware that this is a complete release of liability and the above waivers contains indemnification from you to the Xiaopei Chinese Dance released parties and sign it voluntarily with such knowledge. You also agree that all information filled out in this form is complete and true and hereby give permission for Xiaopei Chinese Dance to contact you via the methods you've selected and provided above.