Registration Form

Adult Registration Form

Village Arts School of Dance
Person 1: Full Name*

First NameLast Name
MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Date of birth
Person 2: Full Name

First NameLast Name
MaleFemale
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
E-mail
example@example.com
Have you had any previous dance training?

YesNo
Please Specify
What class(es) are you signing up for? Select all that apply

Tuesdays:Adult Jazz: 15+Wednesdays:Adult Tap: 15+Thursdays:Adult Ballroom Basics: 15+Adult Stretch and Strengthen: 15+Other
Declaration by Person(s) participating:

I herby absolve "the studio" from any liability related to injury while participating or fulfilling duties of the school.
I have read and agree to the above statement*

Yes
Signature*

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Adult Registration Form