Registration Form

Dancer Name*

First NameLast Name

Birth Date*

MonthDayYear

Parent/Guardian Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Emergency Contact*

First NameLast Name

Relationship to Dancer*

Phone Number*

Area CodePhone Number

Session*

Classes/Programs*

Class Day and Time Selection

See schedule for class day and time offering

I am interested in dance exams

YesNoNot sure, please send me more informationN/A

Is there anything else we should know about your dancer/performer such as allergies or injuries?

Please list all previous dance and/or theatre experience.

I, the parent and/or guardian of the above dancer understand that dance is a physical activity and I confirm that I or/and my child is in good physical health and is fully able to participate in the selected activity.

I, the parent and/or guardian of the above dancer releases and discharges Belle Pointe Dance & Movement Company and it's faculty and staff from any and all actions, causes of action, for damage, loss or injury, arising which may be sustained by the dancer in consequence of their participation in classes at the school, or events organized by the school, such as recitals. I acknowledge that dance is a physical activity and the potential risk for physical injury does exist. Any use of the facilities and services are undertaken at our own risk and responsibility, and Belle Pointe Dance & Movement Company shall not be liable for claims, demands, injuries, damages, or actions. I expressly and forever release the school, its management, employees, directors, and instructors from all claims, demands, damages and actions by myself, my children or dependents by reason of the use of any and all facilities.

Belle Pointe Dance & Movement Company has taken enhanced health and safety measures for the benefit of all students and staff to meet or exceed the minimum legislated standards. These measures will be shared with all families, and will be updated as required over time. Students and parents must follow all provided instructions related to these measures. By visiting Belle Pointe Dance & Movement Company, you voluntarily assume all risks related to exposure of viruses or outbreaks of any kind.

Belle Pointe Dance & Movement Company shall not be held responsible for any loss or theft of personal possessions.

All students enrolled at Belle Pointe Dance & Movement Company must agree to abide by all studio policies set forth by the school. Failure to comply with rules and regulations could result in dismissal from Belle Pointe Dance & Movement Company.

I have read, understand and agree to all the conditions listed above:*

I agree

We are very proud of our dancers and their accomplishments and love to document their progress. Pictures may be taken of during special events and performances and these pictures may be used for promotional use and advertising. We respect your privacy, if you do not want to have your or your child's photo taken please indicate your wishes below.*

Pictures may be takenNo pictures please

Your registration is almost done! A BPD representative will review your registration application and send you a confirmation that will include your class day(s) and times(s), studio policies, dress code requirements and payment options. Thank you for choosing Belle Pointe Dance & Movement Company.

To ensure that you receive a speedy reply please be sure to add inquiries@bellepointedance.ca to your email contacts or safe senders list.

REGISTRATION FORM

DANCER INFORMATION:

PARENT/GUARDIAN INFORMATION:

EMERGENCY CONTACT INFORMATION

CLASS/PROGRAM INFORMATION