Registration Form

Registration Form

Fiesta Mexicana Dance Company
On behalf of Fiesta Mexicana Dance Co. we would like to welcome you and your family. Our mission is “Promoting our Culture and Helping our Children.” We hope that you can have fun and learn the most out of this dance class. Our main goal is for you to become a member of our dance group and participate in our performances. If you have any questions or concerns, please feel free to approach any one of the dance instructors or one of our board members.

Sincerely,

Luis Hernandez

Director of Drug Elimination Family Awareness Program

Fiesta Mexicana Dance Company
DANCE FEES

Registration Fee: $25

Monthly Dance Fee:

1 Dancer $75

2 Dancers $115

3 Dancers $140

4 Dancers $175

The dance fee and registration fee are due at the time of registration or on the first day class is attended.

The monthly fee is due on the first practice of each month. Please call to let us know if you will be late or if there is a problem paying the monthly fee.

RULES AND REGULATIONS
- Girls need to wear their hair in a bun.
- Girls need to wear black leotard, tights, and leggings.
- Girls need a pink bandana every day.
- Boys must wear black shorts or exercise pants and a white or black shirt with no graphics.
- Boys need a red bandana every day.
- Boys and girls need their dance shoes or boots and ballet slippers every day.
- It is important that dancers be prompt and prepared by the beginning of class.
- During performances if dancers or singers forget any part of their outfit they will not perform.
- In order to perform dancers must attend practices a week prior to each performance.
- Dancers need to remain in the practice room at all times.
- Dancers need to notify the teachers before leaving the building any time during or after practice.
- Dancers can bring water bottles to practice.
- No food or soft drinks will be allowed during practices.
- Please let us know at least 48 hours in advanced if your child is unable to attend a performance.
- Absolutely NO gum, jewelry, and cell phones should be used in the practice room or performances. Leave all valuables at home.
- No gossip of any kind will be tolerated inside or outside of the group by dancers or family members. Anyone found gossiping will be penalized.
I have read the list of rules and regulations of Fiesta Mexicana Dance Co. and agree to comply with the above rules and regulations established by the Director and the board of Fiesta Mexicana Dance Co. Parent Signature Below: *

Powered by Jotform SignClear

Registration
Children Participant #1*

First NameLast Name
Date of Birth:*

MonthDayYear
Date
Children Participant #2

First NameLast Name
Date of Birth:

MonthDayYear
Date
Children Participant #3

First NameLast Name
Date of Birth:

MonthDayYear
Date
Children Participant #4

First NameLast Name
Date of Birth:

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Please list any medical conditions/allergies the participant may have: *

Release of Liability
I Name* voluntarily enroll myself/my child Dancers Name* in the Fiesta Mexicana Dance Company dance classes. In doing so, I relieve Fiesta Mexicana Dance Company and the City of Phoenix of any and all liability associated with the dance classes or performances.

Fiesta Mexicana Dance Company does not provide student accident insurance for the medical costs of accidental injury to the student. This must be provided by the parent or guardians. DEFAP/ Fiesta Mexicana prohibits discrimination on the basis of race, color, sex, national origin, and or / disabling conditions, such as, but not limited to, human immunodeficiency virus or acquired immunodeficiency syndrome in its programs activities. DEFAP / Fiesta Mexicana and its board members reserve the right to refuse service.
Name: *
Date*

MonthDayYear
Date
Signature*

Powered by Jotform SignClear

Questionaire
Have you danced with another group before?*

YesNo
If yes, with whom?
Why are you interested in joining Fiesta Mexicana?*
What are your expectations of the group?*
Are you willing to volunteer your time to help with the group?*

YesNo
How did you hear about the group?*
Comments: *

Copyright Agreement
To Whom It May Concern:

All rights reserved to the group Fiesta Mexicana and its director, Luis Hernandez. Any Public use of outfits, dances, and props are prohibited. Federal law provides severe Civil and Criminal penalties for the unauthorized reproductions of dances, costumes, and props. Criminal copyright infringement is investigated by the FBI and may constitute a felony with a fine.
Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date

Permission to Participate and Transport
I hereby give permission for Dancers Name to participate. I agree to direct my child/children to cooperate with the directions and instructions of the group. Should it be necessary for my child to have medical treatment while participating in this event, I give the teachers/supervisors permission to use their judgment in obtaining medical treatment for my child/children. I also give permission for a physician to treat my child/children if necessary. I release and discharge all dance teachers and the City of Phoenix from any and all liability arising from this event.
Parent/Guardian*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Relation to Dancer*
Phone *
Please enter a valid phone number.

Photo/Public Release
To Whom It May Concern:

The Drug Elimination Family Awareness Program (DEFAP) and Fiesta Mexicana Dance Co. has my permission to utilize photographs and/ or videos of myself of my child/ren to assist in the publicity of DEFAP and its programs.
Participants Name*

First NameLast Name
Parent/Guardian*

First NameLast Name
Date*

MonthDayYear
Date
Signature*

Powered by Jotform SignClear
Should be Empty:

Registration Form

Registration

Release of Liability

Questionaire

Copyright Agreement

Permission to Participate and Transport

Photo/Public Release