Fall/Winter 2023 Dance On Weekly Online Class Drop In Registration

Dance On Weekly Online Class Registration - Fall/Winter Series

September 12, 2024 - December 19, 2024
Thursdays 11:00 AM – 12:00PM ET on Zoom

As part of our Dance On creative aging program, this online class uses the power of moving and making to cultivate connection, creativity, and greater health at all ages. Classes are led by DX artists, including the members of our Dance On OAC Cohort. Pre-registration required.

This class is for older adults, but all ages are welcome.

Registering for the Dance On Class Series gives you access to all CLASSES during each registered season on the following dates:

Fall / Winter Season - 14 sessions
9/12/24
9/19/24
9/26/24
10/3/24
10/10/24
10/17/24
10/24/24
10/31/24
11/7/24
11/14/24
11/21/24
12/5/24
12/12/24
12/19/24

No Class:
11/28/24
12/26/24
Participant Information

Please list information for the person who will be participating in class.
Participant Name*

First NameLast Name
Participant Email*
example@example.com
Participant Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you live or work in Takoma Park? Select all that apply.

LiveWorkOut of the area
Would you like weekly email reminders for class? We can send you an automated email each week with a class reminder and the Zoom link.

Yes, email me weekly.No, thanks.
How did you hear about our program?
Dance Exchange Mailing List

Yes, subscribe me to the Dance Exchange mailing list. You can unsubscribe at any time.
Emergency Contact Information
Emergency Contact *

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Liability and Media Release

Before registering, please read the following disclaimers. By clicking "I agree", you are agreeing to the following:
LIABILITY RELEASE: I acknowledge that I have voluntarily enrolled myself in this program and assume responsibility for all risks of injuries resulting from our participation in activities with Dance Exchange. I certify that I am physically and mentally capable of participating in these activities. I hereby represent that I have informed Dance Exchange of any pertinent medical conditions that may affect participation in these activities, including but not limited to classes, rehearsals, performances, or related events. I voluntarily agree to release, discharge, and hold harmless Dance Exchange for any and all claims of liability which causes injury, whether based on allegations or not, in any way. Should emergency medical services become necessary for the undersigned participant, the expenses are the sole responsibility of myself and not that of Dance Exchange. I understand that this is the entire agreement between myself and Dance Exchange, its owners, officers, board, agents, and employees and that it cannot be modified or changed in any way by the representatives or statements by Dance Exchange or by myself.*

I agree
MEDIA RELEASE: I, hereby grant to Dance Exchange the irrevocable and unrestricted right to use and publish, alter, and copyright quoted material, photographs or video images of myself, audio recordings, text/writings/drawings I produce for Dance Exchange publications, electronic reproductions (website) and/or any other purpose and in any manner or medium an unlimited number of times in perpetuity for any lawful purpose. I hereby release the photographer/videographer/documenter and the Dance Exchange from all claims and liability relating to said photographs/video/audio/text. I understand that the Dance Exchange will exercise care in protecting the context of quoted material or image. I understand that I will not receive any monetary compensation for the permissions I am granting herein. I understand cannot withdraw this consent after I sign this form and that this consent and release is binding.*

I agree
Payment

Please select the sliding scale class fee with which you are most comfortable. Paying at a higher end of the scale, if you are able, helps keep the class affordable for everyone.*

Dance On Weekly Class Fall/Winter Sliding Scale - Option 1$5 per class

$70.00

Dance On Weekly Class Fall/Winter Sliding Scale - Option 2$10 per class

$140.00

Dance On Weekly Class Fall/Winter Sliding Scale - Option 3$15 per class

$210.00

Dance On Weekly Class Fall/Winter Sliding Scale - Option 4$20 per class

$280.00

Total

$0.00

Credit Card Details
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Credit Card Number	Security Code
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Dance On Weekly Online Class Registration - Fall/Winter Series

Participant Information

Emergency Contact Information

Liability and Media Release

Payment