CLUB H ALL STARS: DANCE TEAM INTENSIVE
A dance intensive designed for advanced dancers seeking to elevate their training in dance team styles & technique. $170.00/per dancer - payment to @Nicole-Pollzzie thru Venmo to reserve your spot.
Dancer Name
*
First Name
Last Name
Dancer Age
*
-
Month
-
Day
Year
Date
Dancer Grade (2025/26 School Year)
*
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Please enter a valid phone number.
Emergency Contact & Phone Number (please include 2 Contacts)
*
Experience Level
*
Allergies or Health Conditions
*
Consent for Photos/Videos - Do you give permission for your child's photos or videos to be used for promotional purposes?
*
Yes
No
RELEASE OF LIABILITY
**"By enrolling in Haja Dance Co’s summer dance classes, I acknowledge that dance involves physical activity and inherent risks. I release Haja Dance Co, its instructors, and staff from any liability for injuries or accidents that may occur. I confirm that my child is in good health to participate. Participation is at my own risk."**
**"Please sign your name below to acknowledge and agree to the above statement."**
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