Adult Workshop Registration Form
  • Adult Workshop Registration Form

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            Select your Class Quantity
            Britney | Friday, March 20 | 7:00-8:30pm

            Select your Class Quantity
            Mobility | Wednesdays, February 4-25 | 11:30-12:30pm
            Dance for Seniors | Wednesdays, March 4-25 | 11:30-12:30pm
            Ballet | Wednesdays, April 1-22 | 11:30-12:30pm
            Mobility | Wednesdays, June 3-24 | 11:30-12:30pm

            Quantity
            Mondays | March 2-March 23 | 6:30-7:30pm

            Quantity
            Tuesdays | March 3-24| 7:15-8:00pm

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            Credit Card Details
          • NPD collects basic demographic information for federal grant purposes only. This information will be kept anonymous and confidential.
          • LIABILITY RELEASE: I hereby release Northern Plains Dance or Ballet (NPD) and its agents and employees from all liability for personal injury, illness (including exposure, infection and/or spread of COVID-19) or property damage occurring on or off premises used, rented, leased, or owned by NPD. I certify that I am in good health and capable of participation in all activities and classes. I understand that NPD will not provide alcoholic beverages to me, and that in order to consume alcohol(BYO events only), I must present a valid photo identification upon entering the premesis.

            MEDICAL RELEASE: In an emergency, I authorize NPD, its employees and agents, in the event that I cannot be reached by telephone at the number(s) listed above, to transport and admit my child or myself to a local hospital for the purpose of emergency medical treatment. I release NPD, its employees and agents, from any liability incurred for the transportation and admission of myself or my child to a local hospital for emergency treatment.

            PHOTOGRAPHY RELEASE: I hereby give permission to NPD to take photographs and/or videos of me or my child that will become permanently property of NPD. I consent to the use of such materials for promotional purposes by NPD.

            I HAVE READ THIS ENTIRE RELEASE, I FULLY UNDERSTAND IT, AND AGREE TO BE LEGALLY BOUND BY IT.

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