Atlanta Lit Squad Registration
Dancer Information
First Name
Last Name
Gender
Male
Female
Child Division
Mini (6-9)
Jr (10-12)
Sr (13-19)
Birth Date
Grade Level
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Parent/Guardian Information
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Emergency Contact
Name
First Name
Last Name
Relationship
Please Select
Aunt/Uncle
Grandparent
Family Friend
Phone Number
Format: (000) 000-0000.
Alternate Number
Format: (000) 000-0000.
Does the dancer has any allergies, chronic Illness, or Medical Condition? If Yes please describe
Does your child has asthma
Yes
No
Tell Us About Your Child Dance Experience
Copy of child birth certificate
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Practice Schedule
Monday: 6:00pm-8:30pm Tuesday: 6:00pm-8:30pm Thursday: 6:00-8:30pm Sunday: TBA
Monthly Fees
Monthly dues are $100 and will be due on the 1st of each month. If dues are paid after the 5th of each month, there will be a $25 late fee applied after the 5th. After The 7th Dues Are $150 ‼️Monthly dues are collected to pay for rehearsal space,classes and to reduce competition costs where possible. Fees Are Due In Cash Only . Please put in envelope and your child name written in front.
Commitment
Participation on the Atlanta Lit Squad Competition Squad is a great deal of fun but, it requires a significant commitment from members as well as their parents. A great deal of time and effort is needed to be successful so members and parents should decide if they are willing to make such a commitment before joining the team.
Informed Consent and Acknowledgement
I hereby give my approval for my child’s participation in any and all activities prepared by Atlanta Lit Squad during the 2022 year. In exchange for the acceptance of said child’s candidacy by Atlanta Lit Squad ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Atlanta Lit Squad and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected dance competitions.In case of injury to said child, I hereby waive all claims against Atlanta Lit Squad including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities.
Media Release and Authorization
As Parent and/or Guardian of the named Dancer, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.Permission is also granted to the Coach Of Atlanta Lit Squad and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.Release authorized on the dates and/or duration of the registered season.This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Do You Agree To Everything You Just Read?
Yes
No
First Payment Of $75 Due Thursday 01/13/22 - Remaining Balance Of January Fees.
Please check monthly fees category for monthly tuition information. UNIFORM PACKAGE TBA
Submit
Should be Empty: