Registration Form
Fill out the form carefully for registration. If you are registering more than one person, please complete this form again for each additional person.
Parent/Guardian Name or Main Contact
*
First Name
Last Name
Parent/Guardian or Main Contact Email
*
example@example.com
Mobile Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you registering for yourself?
Yes
No
What Class Are You Registering For?
Adult
Youth (12+)
Additional Comments
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Are you registering for your free trial class?
Yes
No
Please select your Free Trial Date
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Liability Waiver
* I/we realize that 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 (the dancer and/or parent/guardian) assume all risks related to the use of any and all spaces used by Stage Presence Dance.
* I/we agree to release and hold harmless Stage Presence Dance including its teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold Stage Presence Dance 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 behavior in addition to any damage I/we may cause to the facilities utilized by Stage Presence.
* I understand that Stage Presence Dance is a licensed and insured business. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the Owner, Director, Instructor or Staff member as soon as possible
Photo/Video Release: I understand that Stage Presence may take photos and videos of myself or my child for future promotions of programs and events.
*
I agree
Signature
*
My Products
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( X )
8 Week Session Tuition - Adult Tap
You can choose to pay weekly if that is better for you - simply use code WEEKLY25 to make a deposit and then pay the rest over the next 8 weeks! Please use code TRIAL26 to bypass payment for your trial class
$
160.00
Quantity
1
2
3
Payment Methods
Choose from one of the PayPal options to
make your payment.
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