Couples Dance Class Sign Up
Must be 18 years or older. All Participants must be dressed in appropriate dance attire.
Class Day:
Friday Evenings
Location:
214-10 41st Ave Bayside NY 11361
Start Time:
8-9pm
Participant Information
Full Name
*
First Name
Last Name
Age
*
DOB
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Emergency Contact Details
Contact Person
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Relationship
Waiver & Release
Please confirm
*
I confirm that I am in good shape, health, and condition.
Please confirm
*
I don't have any medical condition or medical history that will affect my participation in this event
Please confirm
*
I acknowledge that this yoga/fitness class requires physical activity and there are possible risks and danger.
Please confirm
*
I release Forever Dancing, LLC. organizers for any responsibility in case of an accident, illness, or injury.
Please confirm
*
I confirm that all information in this registration form is accurate and true.
Participant's Signature
*
Date Signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
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