Kingdom Arise Movement Enrollment Form

Student Full Name

First NameLast Name

Date of Birth

Date

Age

Dance experience if so what?

Parent/Guardian Full Name

First NameLast Name

Parent Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address

example@example.com

Preferred Dance Style

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Email

example@example.com

Relationship to student

Is your dancer interested in competitions or traveling?

Any physical limitations or injuries we should know about?

Medical conditions or Allergies? (Asthma, seizures, heart conditions ,Diary ,Eggs, Nuts etc.)

I understand that consistent attendance is required for my dancer to participate in performances

I understand that repeated unexcused absences may result in my dancer being moved, removed from parts, or not performing certain pieces

I understand that Kingdom Arise Movement is a faith-based, family-oriented program and we expect dancers and parents to show respect at all times

I agree to check Band messages, emails, and/or chats from coaches regularly for important updates, costume info, events, and schedule changes

I understand that tuition, fees,costumes fees, and recital fees are non-refundable

I understand late payments may result in late fees and/or my dancer being temporarily unable to participate until the account is brought current

Interested in applying for a KAM scholarship? (Director will reach out with more info if so )

I understand that Kingdom Arise Movement (“KAM”) may photograph, film, or otherwise record my dancer during classes, rehearsals, events, and performances. I give KAM permission to use these photos and videos on social media, websites, flyers, advertisements, and other promotional materials.I understand that all photos, videos, and recordings created by KAM staff or our official media team are the property of Kingdom Arise Movement and may be edited, posted, or shared at the director’s discretion. I understand that I will not receive payment or compensation for the use of these images or recordings.I agree not to alter, rebrand, or use KAM photos/videos for any business or promotional purpose without written permission from the director. Personal sharing (reposting, stories, etc.) is welcome as long as it does not misrepresent KAM or the choreography.

Liability & Responsibility Acknowledgment By completing this registration, I understand and agree to the following:I understand that dance and physical activity involve inherent risks, including the risk of injury. I agree that Kingdom Arise Movement (KAM), its owners, directors, staff, and volunteers are not responsible for any injury or accident that may occur before, during, or after classes, rehearsals, events, or performances, except in cases of gross negligence.I understand that KAM is not responsible for lost, stolen, or damaged personal property, including but not limited to phones, jewelry, clothing, shoes, bags, or money brought by dancers or family members.I understand that KAM staff are only responsible for my dancer during their scheduled class or rehearsal time. KAM is not responsible for supervision of dancers who are dropped off early, picked up late, or left on the premises outside of their scheduled time.I understand that transportation to and from all classes, rehearsals, and events is my responsibility as the parent/guardian, and KAM is not responsible for dancers once they leave the building or event space.I understand that it is my responsibility to keep my contact information up to date and to check messages, texts, and/or emails for important updates. KAM is not responsible for missed information due to outdated contact details or unread messages.