DPAZ Summer CAMP @ Studio Z

DPAZ Upcoming Events & Registration!

Held at Studio Z: 9153 E Bell Rd, Scottsdale, AZ 85260
Dancer's Information
Dancer's Name

First NameLast Name
Birth Date

MonthDayYear
Gender

MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Information
Name

First NameLast Name
Primary Number
Secondary Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Does the athlete have any allergies, chronic illness, or medical conditions? Or need an inhaler? If yes, please describe.
How did you hear about us? And are you interested in having a Dance Party AZ Birthday Party? If yes, we will send an info packet to the email provided above.
INFORMED CONSENT AND WAIVER OF LIABILITY

References to parents/children visiting/renting at Studio Z Performing Arts Center for leisure activities/celebrations. I hereby knowingly and voluntarily assume all risk inherent in my participation at the event held at Studio Z Performing Arts Center including the risk of injury, accident, illness, death, loss, cost, or damage to my person or property. I also hereby release and indemnify Studio Z Performing Arts Center, Dance Party AZ and its Instructors and any other participant in event/class from and against any and all claims and liabilities, including attorneys’ fees, in any way resulting from or relating to my participation.

I further attest that I am in good physical health, and/or that I have consulted with a physician and I am able to undertake and engage in the physical movements and actions taught in the Event. I assume all responsibility for any medical conditions, or changes in medical conditions, that might affect my safety or participation in the Event.

Additionally, I understand that these events/classes may be recorded and/or photographed, and I consent to Studio Z Performing Arts Center and Dance Party AZ using these recordings and/or photographs in promotions that include, but are not limited to, social media and marketing.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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Date
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DPAZ Upcoming Events & Registration!

Dancer's Information

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