Adult Ballet Lessons

Adult Ballet Lessons
Full Name *

First Name Last Name
Preferred Skill Level *

beginner Intermediate
Preferred Pronouns *
for example: she, her, hers, he, him, his, or they, them, theirs
Phone Number *
E-mail *
You will receive class info here
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency contact person *

First Name Last Name
Emergency contact phone *
Emergency contact phone
What would you like to gain from class
How did you hear about us? *
Waiver of Liability & Photo Release

Waiver of Liability & Photo Release By signing below I agree and understand that I acknowledge that this is a physical active and inherently involves a small risk of injury. I understand that this activity will involve Theatre Arts related activities. I hereby agree to hold T3 Triple Threat Youth Mentors (T3), or any of its affiliates harmless for any injury to myself/my child resulting from me/my child’s participation. I will not sue T3 or any of its affiliates for any injury, loss or property or damage resulting from participation in this activity. Additionally I give my permission and understand T3 may use any photos and video footage taken for promotional purposes. These materials may be used at any time.
Name *

First Name Last Name
Date

Month Day Year
Date
Should be Empty:

Waiver of Liability & Photo Release