Recreational Registration Form: 2025-2026 Dance Season

Recreational Registration Form: 2025-2026 Dance Season

NEW REGISTRATION PROCESS: Please fill in the form below to register for the upcoming Fall Classes. Tuition fees will be provided following your submission, according to your class selections. We will contact you with your tuition breakdown and payment options before your first payment is required. You will have a Dance Studio Pro account created for you, if you don't already have one, based on the information provided in this form. -- If you have any questions or concerns regarding tuition fees or our 2025/26 Dance Season, please email us at the following email: info@creativeconnexions.ca .
Participant's Information:
Full Name*

First NameLast Name
Birth Date:*

MonthDayYear
Date
Gender*

FemaleMaleOther
Preferred Pronouns:*
Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Phone Number*
Contact E-mail*
example@example.com
Parent/Guardian Information 1:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Relationship to Participant:*
Parent/Guardian Information 2:
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship to Participant:
Emergency Contact Information:
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Alt. Phone Number
Please enter a valid phone number.
Relationship to Participant:*
Please list any health concerns or information regarding your participant that our staff should be notified of:
How did you hear about us?*
Please Specify

Participation Waiver:
I am aware that the participation of myself/child in dance, acrobatic dance, and barre fitness related activity involves inherent risk and hazards. I understand that the activity that myself/my child is participating in is a barre fitness, dance, acrobatic dance class. I freely accept and fully assume (on behalf of myself or my son/daughter) all such risks, dangers, and hazards and the possibility of injury, illness, property damage, or loss resulting from such risks and hazards. I voluntarily agree to release Creative Connexions Performing Arts Center from any and all liability for any loss, damage, illness, injury or expense that myself or my child may suffer or incur as a result of participation in barre fitness, dance, and acrobatic dance lessons, including negligence on the part of Creative Connexions Performing Arts Center, its owner, staff, and/or contractors. I understand that this waiver includes, and is not limited to, the transfer of programs through a virtual format. As the Parent or Guardian of the above stated participant, if I cannot be contacted, I authorize Creative Connexions Performing Arts Center to seek medical services in case of serious injury or illness. I further agree to accept financial responsibility in excess of benefits allowed by my health plan. I understand that Creative Connexions Performing Arts Center employees and/or contractors will not assume responsibility for any lost or stolen property, or for any bodily or personal injury consisting of or arising out of any participating in any physical training or athletic activity.
As the Parent/Guarding of the Participant or the Participant (18 years or older):*

Agree, and fully consent to the Participation Waiver.Disagree, and do not consent to the Participation Waiver.
Photo & Video Release and Acknowledgment & Agreement:
I hereby acknowledge that all right, title, and interest video(s) and/or photograph(s) in which myself/my child has participated, being original works, belong to Creative Connexions Performing Arts Centre and that the said video(s) or photograph(s), titles and other constituents were prepared under the direction and control of Creative Connexions Performing Arts Centre. I hereby release Creative Connexions Performing Arts Centre from all claims, which I may have now or in the future, for compensation of any kind arising out of myself/my child's participation in said video(s) and/or photography(s) at this time, but may do so at its own discretion at a later date. Creative Connexions Performing Arts Centre reserves the right to discontinue use of video(s) and/or photography(s) without notice. I acknowledge that I have carefully read this agreement in its entirety, that I have executed it voluntarily and that this agreement is binding. I consent to and authorize that use by Creative Connexions Performing Arts Centre, or anyone authorized by Creative Connexions Performing Arts Centre (including associates, employees, agents, or representatives), of any and all video(s) and/or photography(s) that have been taken of my child/children. I understand that this includes all programs that may be provided in a virtual format.
As the Parent/Guardian of the Participant or the Participant (18 years or older):*

Agree, and fully consent to the Photo & Video Release and Acknowledgement.Disagree, and do not give consent for my participants image to be used for any photography or videography to be used by Creative Connexions Performing Arts Centre. I understand this will mean my dancer will not be featured in any slide show at studio events (including recital) or be able to take a group photo with other dancers in their class during photo day.
Confirmation:

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATIURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE AND IS APPLICABLE TO THE ABOVE STATED PARTICIPATION WAIVER AND PHOTOGRAPHY & VIDEO RELEASE AND ACKNOWLEDGEMENT AGREEMENT. THIS SIGNATURE CONFIRMS THAT THE EMERGENCY CONTACT INFORMATION IS ACCURATE AND TO BE USED IN THE EVENT OF AN EMERGENCY. I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES ATTACHED TO THIS REGISTRATION FORM.
Signature:*

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Recreational Registration Form: 2025-2026 Dance Season

Emergency Contact Information:

Please indicate what class/classes you would like your dancer to participate in.

Who Am I?

Participation Waiver:

Photo & Video Release and Acknowledgment & Agreement:

Confirmation: