AC Twirlers/ Mount Vernon/ Howard Twirling Club Registration Form

AC Twirlers/ Mount Vernon/ Howard Twirling Club Registration Form
Please fill out 1 form per child

Please select the class that best fits your schedule. Classes will begin November 2nd and end April 10th. Participation in non competitive teams is $200 - includes a baton, recital costume, and t-shirt. Returning students that do not need a baton will be $180. If your student is in need of a scholarship due to financial difficulties, please send a message to alisha@actwirl.com
Parent/ Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Student Name

First NameLast Name
Student Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Student Grade Level
T-shirt Size
Recreational Teams:
Competition Teams:
Liability Waiver:

I agree to assume the risk of any injury that may happen to me (or my child) as a result of participation in the AC Twirlers/ Danville/ Howard or Mount Vernon Twirling Clubs. I understand that twirling a baton can come with some risk of injury, though not likely. I further agree to indemnify and hold the AC Twirlers and their agents, or employees harmless from any loss sustained as a result of injury to me (or my child) as a result of participation in the Twirling Clubs.
Liability Waiver
Video/ Picture Release:

Many times we share photos or videos on our social media platforms. Mostly to share with our twirling families.
Photo/ Video Release
Signature
Should be Empty:

AC Twirlers/ Mount Vernon/ Howard Twirling Club Registration Form

Please fill out 1 form per child

Liability Waiver:

Video/ Picture Release: