The Joffrey Ballet/Northwestern Medicine "Dancing with Parkinson's" Lake Forest Spring Session

The Joffrey Ballet/Northwestern Medicine "Dancing with Parkinson's" Spring Session in Lake Forest

Registration Page
Welcome to the registration page for the Spring Session of Dancing with Parkinson's classes at our Lake Forest Location! We will be accepting 35 participants for class at this time. Registration will close and a waitlist will open if/when class reaches capacity.
CLASS DETAILS
- Class will take place at the Northwestern Medicine's Lake Forest Health and Fitness Center (1200 N Westmoreland Rd)
- For the Spring Session, class will run on Mondays from 11:30am-12:30pm from March 4th- May 20th (eleven sessions). Please only register if you know you'll be able to make it to at least half of the sessions. Note, classes will not be held on Monday, March 25th.
- You are welcome to register yourself, as well as a family member, friend, or caregiver. Please only register a family, friend, or caregiver if they will actually take class with you.
- The first half of class is seated. All participants have the option to stand halfway through class, but you are welcome to stay seated for the whole duration of class.
THIS FORM IS FOR CLASSES AT OUR LAKE FOREST LOCATION. If you would like to register for our South Loop location, you can do AT THIS LINK.
ATTENDEE INFORMATION
Full Name of Attendee*

First NameLast Name
Name of Supporting Attendee (Family, Friend, Caregiver, etc). Only write down someone IF they will actually be taking class with you.

First NameLast Name
Attendee Email*
example@example.com
Attendee Phone Number*
Please enter a valid phone number.
Attendee Age*
Class will be held on the following dates. Please select the dates you know you'll be able to attend. Note, class will not be held on Monday, March 25th. (We'd love for you to be available for most sessions, but we understand if you need to miss a couple sessions).*

Monday, March 4thMonday, March 11thMonday, March 18thMonday, April 1stMonday, April 8thMonday, April 15thMonday, April 22ndMonday, April 29thMonday, May 6thMonday, May 13thMonday, May 20th
We will be having an optional performance on Sunday, May 19th at 1pm at the Joffrey Tower- Studio A (10 E Randolph St). This would include a) staying 10-15 minutes longer for a few classes so we could stage the dance and rehearse a little more and b) coming to Joffrey Tower on May 19th to rehearse and perform the 3-4 minute dance.*

Yes, I would love to participate in the May 19th performance.I am interested but cannot yet commit to the May 19th performance.No, I am not interested in participating in the May 19th performance.
Do you have any further questions or concerns about the program?
FORMS
Please read through the Joffrey Ballet Community Engagement's 'Release of Liability' below:
Please read through the Joffrey Ballet Community Engagement's 'Media Release' below:
Please read through Northwestern Medicine's 'Media Release' below:
SIGNATURE

By signing below, I agree to the terms of registration and the Joffrey Ballet Community Engagement's 'Release of Liability', the Joffrey Ballet Community Engagement's 'Media Release', and Northwestern Medicine's 'Media Release'.
Attendee Signature*

Clear
While I signed above, I do not consent to the Media Release's above and request to not be in any media (photos, videos, interviews, etc) regarding this class.

(check if you do not consent to the Media Release's above)
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The Joffrey Ballet/Northwestern Medicine "Dancing with Parkinson's" Spring Session in Lake Forest

CLASS DETAILS

ATTENDEE INFORMATION

FORMS

SIGNATURE