Danceground Registration Form
Thank you for your interest in joining us on the Danceground, our come-as-you-are outdoor freeform dancing and movement playground in Western Mass! This is a general registration form for all Danceground events and includes liability waivers and releases. Once complete, you will receive informational emails for the upcoming Danceground you have registered for, as well as all future Danceground events. You can unsubscribe from these emails at any time.
Name
*
First Name
Last Name
Parent/guardian name (if under 18)
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
What Danceground date and location would you like to register for?
*
Autumn Rhythms🍁 Northampton, MA: Saturday, October 25th from 2-3:30pm
Earthbeats 🌱 Northampton, MA: Saturday, September 20th from 2-3:30pm
There is a suggested sliding scale donation between $15 and $25, which will be collected via the methods below when you arrive at Danceground. No one will be turned away for lack of funds. Which method will you be using to pay?
*
Venmo @ren-myers
PayPal @renmyers
CashApp $rendirt
Cash
I am not able to pay at this time
Emotional Support Animals (ESA) are welcome on the Danceground with proper documentation emailed to rendirt@surrendirtlove.com. Animal companions or pets are welcome on the Danceground on a case-by-case basis, with the expectation that they will be tended to by their human. If another Danceground participant has an allergy or concerns about an animal on the Danceground, we will ask that you vacate your animal companion from the Danceground.
Will you be bringing any animal companions or pets with you to the Danceground? Please provide any important details you'd like us to know about your animal companions or pets in the box below.
*
Please list any known animal or pet allergens and the severity of the reactions. We collect this information so that we can make an informed decision when approving any animal companions or pets for Danceground participation.
*
Please read and sign the following access information and expectations about Danceground participation in the signature box below. You will be emailed a copy for your records:
*
I understand and agree to the above access information and expectations
*
Parent/guardian signature (if under 18): I understand and agree to the above access information and expectations for my child/dependent
Please read and sign the following liability waiver in the signature box below. You will be emailed a copy for your records:
*
I understand and agree to the liability waiver above
*
Parent/guardian name (if under 18)
First Name
Last Name
Parent/guardian signature (if under 18): I understand and agree to the above liability waiver for my child/dependent
Please read and sign the photo release in the signature box below:
*
I understand and agree to the photo release above
*
Parent/guardian name (if under 18)
First Name
Last Name
Parent/guardian signature (if under 18): I understand and agree to the above photo release for my child/dependent
Please verify that you are human
*
Submit
Submit
Should be Empty: