Spring Registration

Spring Registration

Beginning January 14th 2026 at The School of Dance
Twirler's Name

First NameLast Name
Parent/Guardian's Name

First NameLast Name
Primary Phone Number

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Twirler's Birth Date

MonthDayYear
Date
Twirler's Age
Twirler's Gender

Other
Emergancy Contact Information

Full NameRelationPhone Number
List any medications, allergies, or medical conditions that we should be aware of.
How did you hear about us?
If applicable, please input the first and last name of the person who referred you.

First NameLast Name

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Liability Release Form and Assumption of Risk
I/we realize that participation in baton twirling classes and activities could result in some possible personal injury. Despite precautions being taken by the studio, accidents and injuries may occur. By signing this release form, I/we (the twirler and parent/guardian) assume all risks related to the use of any and all spaces used by Salt Lake City Twirlers.
I/we agree to release responsibility from the Salt Lake City Twirlers. This includes all teachers, staff members, twirlers, and facilities from any cause of action, claims, or demands now and in the future. I/we will not hold Salt Lake City Twirlers liable for any personal injury including: scrapes, bruises, cuts, sprains, fractures, broken bones, concussions or death or any personal property damage/loss, which may occur on the premises before, during or after classes.
Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Salt Lake City Twirlers.
In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to Emily Jansen, owner of the Salt Lake City Twirlers as soon as possible.
PHOTOGRAPHY/VIDEO – I give permission for my son/daughter’s photographs/videos to be used for publicity and advertising in the studio, on the Salt Lake City Twirlers social media accounts, and in the community.
Twirler's Name

First NameLast Name
Parent/Guardian's Name

First NameLast Name
Parent/Guardian Sign and Date
Should be Empty:

Spring Registration

Billing Information

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Liability Release Form and Assumption of Risk

Spring Registration

Billing Information

Checkout*

Liability Release Form and Assumption of Risk

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