Free Trial Class Sign Up
At Reflexion Dance we strive to foster a welcoming and enriching dance experience for dancers 3 and up. Trial Classes are a great way for your dancer to find the perfect class for their interests! (If filling out for multiple children, please fill out 1 form for each child)
Parent/Guardian Name
First Name
Last Name
Child's Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Child's Age + Class Selection
Date of Trial
-
Month
-
Day
Year
Date
I am aware that participation in dancing is potentially dangerous and involves risk of injury. I understand that these risks include, but are not limited to injury to ligaments, muscles, tendons, bones and other aspects of the body that may include head, neck, or spine. Due to the dangers of this activity, I understand the importance of my child's following the teacher's instructions regarding techniques, training, and other rules and agree that my child will obey these instructions. In consideration for allowing my child to participate in dance classes of Reflexion Dance & Fitness LLC, I hereby assume all the risks associated with the sport of dance and I agree to release Reflexion Dance & Fitness LLC and its employees or agents from all liability/responsibility which may arise in connection with my child's participation in any class(es).
I agree
Any other questions/comments
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