Class Registration Signup Form

Your Awesome Dance Alias (Name)*

First NameLast Name

Your Dance-versary (Birth Date)

MonthDayYear

Gender*

Where You Keep Your Dancing Shoes (Address)*

Street Address

Street Address Line 2

CityState

Zip Code

NavratriNinja@email.com (Email)*

Garba Gossipline (Phone)*

Area CodePhone Number

Garba Giggles Grounds (Preferred Studio Locations)*

Alrighty then, how many classes are you ready to concur on your way to becoming a Garba superstar?

Spill the Garba beans! How did our Garba classes find their way to your radar?*

Who’s your Garba Gossip Dealer? We promise not to interrogate them… much. 😉*

Please describe in order to help us when working with you or your child.

Got any hidden dance moves or surprises? Tell us if there's anything we should know, like secrete allergies to dandiya or an occassional case of "rhythmitis" (an uncontrallable urge to garba dance.

Please describe in order to help us when working with you or your child.

Waiver and Release * You or your child will be participating in a movement activity and as with all movement activities; there may be some risk of injury. While proper body alignment and safety while dancing is taught and reinforced throughout the session, there may be circumstances beyond the instructor’s control. By signing and clicking the registration button below, you will not hold RAAS ROCK STUDIO or it’s teachers responsible for any injury you or your child may receive while participating in the movement activities. By signing below you have informed the teacher of any and all previous injuries or medical conditions that the teacher needs to know in order to insure you or your children’s safety while exercising. Additionally, I agree that Raas Rock Studio is not responsible for any lost or stolen items that may occur while participating in Raas Rock Studio program. This release is effective from the date of registration form submission.

Photo Release * Raas Rock Studio is including photos of students, teachers, and studio activities on its website, Facebook page and printed brochures. I understand that these pictures will be accessible to anyone with internet access; however, no names of subjects will be published. We/I hereby give permission for Raas Rock Studio to use photos on its website, Facebook page, in brochures and/or electronic forms of communication.

Student/Parent/Guardian Signature*

DateTime