Intersession 2020 Registration Only

Local Address *

Parent/Guardian #1
Parent/Guardian #2
Emergency Contact *
Will you buy a class card?

Yes, a 5-class card. Yes, a 10-class card. Yes, a 15-class card. Yes, a 20-class card. No, I will pay per class.
Please let us know which class you intend to take, so that we may have your card ready.

Agreements
FINANCIAL/PAYMENTS POLICY: Class cards are non-refundable and non-transferable. Tuition credits do not apply. All classes must be paid for at the time they are taken. Three-student minimum for class session to be held. Schedule is subject to change.
RELEASE FROM LIABILITY: It is expressly agreed that all exercise, training dancing, participation in classes, and the use of facilities of the Central Pennsylvania Dance Workshop by students is undertaken at the sole risk of students or parents/guardians of minor students. Students and parents/guardians of minor students hereby agree to hold the Central Pennsylvania Dance Workshop harmless, releasing forever its employees, owners, operators, agents, servants, advisors, and assignees from any and all claims for injury and/or property damage.
PHOTO RELEASE: I give CPDW permission to use images of me or my child taken during DPDW activities in CPDW-related publications, including website and social media. I understand that CPDW will not identify individuals by name in any publications nor tag individuals on any social media.
Type a question

I grant permission I do not grant permission
Signature *

Clear
Date *

Month Day Year
Date
Should be Empty: