First time? Register for a trial class! :)

First time? Register for a trial class! :)
Student's Full Name*

First NameLast Name
Student's Date of birth*

MonthDayYear
Date
Parent's/Guardian's Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What city are you in?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What classes do you want to try?*

Contortion / StretchingContortion / Stretching (online)Dubstep DanceDubstep Dance (online)Aerial SilksAerial LyraRings / JugglingRings / Juggling (online)
Contortion, Dance, Rings and Juggling trial class is FREE, please skip the payment form.

Aerial Silks and Aerial Lyra trial class fee is $39.99
If you chose Aerial Silks or Aerial Lyra, please fill out the payment form below.

Please note that you won't be charged when submitting this form. The manager will contact you and confirm the date and time for the trial class before charging the card.
Card number
Expiration date
Security code (CVV)
Cardholder name
Zip / Postal Code
Aerial Trial Class Payment Processing

By signing this document, I authorize Black & Yellow Dance School to charge my card the Aerial Trial class fee of $39.99. I understand that this fee is non-refundable.

Please note that you won't be charged when submitting this form. The manager will contact you and confirm the date and time for the trial class before charging the card.
Acknowledgment of Risk & Waiver of Liability

I understand and agree that in participating in any dance/circus class, workshop, rehearsal or performance, there is a possibility of physical injury. I agree to release and hold harmless Black & Yellow Dance School INC., including its teachers, dancers, staff members, and facilities from any cause of action, claims, or demands now and in the future. I will not hold Black & Yellow Dance School INC. liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. If I am signing this waiver for my child, I certify that I am the parent or legal guardian and have the right to waive these rights.

Furthermore, I understand that I should be aware of my, and/or my child’s physical limitations and agree not to exceed them. I confirm that my child is in good health to participate in this program, and there are no pre-existing injuries, medical conditions, disabilities, or impairments that will prevent my child from participating.

Furthermore, I understand the risks of participating in dance classes and my rights as they pertain to COVID-19, and I understand that I and my child have the option not to participate in Black & Yellow dance classes. By participating in classes, I accept any and all responsibility for transmission of COVID-19 and will not hold Black & Yellow Dance School INC., including its teachers, dancers, staff members, and facilities, liable for transmission of COVID-19.

Photo & Video Release

Further, I authorize and agree that Black & Yellow Dance School INC. may take and use photographs/videos of me and/or my child for purposes of record keeping, advertising, and marketing.
Parent's/Guardian's Signature*

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Date signed*

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Date
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First time? Register for a trial class! :)

Contortion, Dance, Rings and Juggling trial class is FREE, please skip the payment form.Aerial Silks and Aerial Lyra trial class fee is $39.99If you chose Aerial Silks or Aerial Lyra, please fill out the payment form below.

Aerial Trial Class Payment Processing

Contortion, Dance, Rings and Juggling trial class is FREE, please skip the payment form.

Aerial Silks and Aerial Lyra trial class fee is $39.99
If you chose Aerial Silks or Aerial Lyra, please fill out the payment form below.