Non-Competitive Dance Registration Form

Non-Competitive Registration Form
Please fill out every page accurately and to your best knowledge.

*Notice: PLEASE ONLY USE ONE FORM PER DANCER*

PLEASE REVIEW THE "PRICING & POLICIES" PAGE ON OUR WEBSITE BEFORE MAKING YOUR SELECTIONS

Parent/Guardian Information

Please still fill out contact information on this page if you are 18+
Primary Parent/Guardian Name *

First NameLast Name
Primary Parent/Guardian Phone Number*
Please enter a valid phone number.
Primary Email*
example@example.com
Primary Mailing Address*

PO BOX #

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Parent/Guardian Name

First NameLast Name
Secondary Parent/Guardian Phone Number
Please enter a valid phone number.

Payment Plan

This is for future invoicing, no payment is required at this time
Will you be paying in full or monthly?*

Full Annual AmountMonthly Payment PlanSemi Annual Amount

Do you have any questions?

Liability Waiver Form
I/We the dancer and the parent/guardian) realize that the participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we assume all risks related to the use of all spaces used by Rebound Dance Company and Jesse Berry.

I/We agree to release and hold Jesse Berry including all staff members and facilities used by Rebound Dance Company from any cause of action, claims, or demands now and in the future.

I/We will not hold Rebound Dance Company or Jesse Berry including all staff members liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes.

Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behaviour in addition to any damage I/we may cause to the facilities utilized by Rebound Dance Company or Jesse Berry.

If, in the event that I/we should observe any unsafe conduct or conditions before, during or after classes. I/we agree to report the unsafe conduct or conditions to Jesse Berry as soon as possible.
Primary Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

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Date Signed*
Dancer's Name *

First NameLast Name
Dancer's Signature (18+ ONLY)

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Date Signed

Rebound Dance Company Photo/Video Release Form
Students of Rebound Dance Company may have the opportunity to be photographed or video taped at various dance events and classes. With permission from parents these photos or videos may be included for Rebound Dance Company publicatons or advertsements, including on our website and various social media sites. To ensure privacy, specific names of children will not be included.

No financial compensaton shall be given for use of any photographs or videos.

I acknowledge that Rebound Dance Company may choose not to use my photo or video at this time, but may do so at its own discretion at a later date.

Rebound Dance Company reserves the right to discontinue use of photos or videos without notice.

I have read this release and I understand its contents.

I consent to and authorize the use by Rebound Dance Company, or anyone authorized by Rebound Dance Company, of any and all photographs or videos which have been taken of my child/children.
Primary Parent/Guardian Name*

First NameLast Name
Signature*

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Date Signed*

MonthDayYear
Date
Dancer's Name*

First NameLast Name
Dancer's Signature (18+ ONLY)

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Date Signed

MonthDayYear
Date
Should be Empty: