Clone of Triple Threat Training & Broadway Babies Registration

Parents' Night Out

Whether you’re shopping, wrapping, or just relaxing… drop the kids off with us for Parents' Night Out! Children will enjoy a Christmas-themed evening filled with dancing, crafts, and games - happily entertained while you get those grown-up tasks done.

Pricing:
• $40 for your first child
• $30 for your second
• $10 for each additional child

Ages 1+

Additional Options:
Dinner: $5 per child for Domino's pizza, a side of chips or similar, and a treat

Two Dates and Locations to choose from!

Saturday, December 13th
4:30–9:30pm
Dulles - NEW Rise Dance Center Location
1306 Squire Ct, Unit C
Sterling, VA 20166

Saturday, December 20th
4:30-9:30pm
Lucketts - Faith Chapel Gathering Place
14188 Chapel Ln
Lucketts, VA 20176
Please choose the number of students who will be attending Parents Night Out:
Up to 4 students can be included on a single form submission. Please submit a second form for additional students.

Parent/Guardian Information
Primary Contact Name*

First NameLast Name
Primary Contact Phone Number*
Please enter a valid phone number.
Primary Contact Email Address*
example@example.com

Agreement and Payment Info

Please review and complete all sections below, then click the "Submit" button
Terms - all sections are required*

1. LIABILITY - I, the undersigned parent and/or legal guardian of the student(s) attending, do hereby give permission for the aforementioned person (or persons) to participate in any and all class-related classes, programs, shows, and events offered by the Center. I accept all risks associated with that participation and understand that there is a full possibility of serious physical injury. I understand and accept that the Center, its staff, instructors, or their landlords are not responsible for injury to myself or my child(ren), whether based on allegations or not, in any way, by any reason of my participation in the Center’s classes, rehearsals, performances, and/or any other related events. I also affirm that I now have and will continue to carry proper medical, health, hospitalization, and accident insurance, which I consider adequate for my dancer. I understand and accept that the Center is not responsible for the immediate medical needs of its students. In consideration thereof, I agree to keep updated emergency contact information on file where a contact person may be reached during class, classes, rehearsals, performances, and related programs/events. I understand and accept that dance instruction may include or require an instructor to physically touch a dance student during class time for purposes of alignment or correction of proper dance technique. I understand and accept that the Center will not be held responsible for any loss or damage to any personal property brought onto the premises or at performance/rehearsal sites.2. MEDIA RELEASE - I understand that photos and videos may be taken. I understand and agree that my child's image/likeness may be used in advertising, press releases, or social or print media without expectation of recompense.3. PAYMENT - All registrants will receive an invoice via the email provided that must be paid before attending.
I have read and agree to the terms above*

First NameLast Name
Should be Empty:

Student 1 Information

Student 2 Information

Student 3 Information

Student 4 Information

Parent/Guardian Information

Agreement and Payment Info