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 / StretchingDubstep DanceAerial SilksAerial Lyra
Contortion & Dance trial class is FREE.

Aerial Silks and Aerial Lyra trial class fee is $39.99
If you chose Aerial Silks or Aerial Lyra, we will contact you to submit the payment and then confirm your trial class.
Aerial Trial Class Payment Processing

By signing this document, I authorize Black & Yellow Dance School to charge my card over the phone. the Aerial Trial class fee is $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/time for the trial class and then take your card information over the phone.
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*

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

Contortion & Dance trial class is FREE.Aerial Silks and Aerial Lyra trial class fee is $39.99If you chose Aerial Silks or Aerial Lyra, we will contact you to submit the payment and then confirm your trial class.

Aerial Trial Class Payment Processing

Contortion & Dance trial class is FREE.

Aerial Silks and Aerial Lyra trial class fee is $39.99
If you chose Aerial Silks or Aerial Lyra, we will contact you to submit the payment and then confirm your trial class.