Class Registration Form Dancer InformationDancer(s)' NameFirst NameLast NameBirthdayAge Parent/Guardian InformationParent/Guardian's Name First Last Address Street Address City State / Province / Region ZIP / Postal Code Cell PhoneHome PhoneEmail Dance Experience: Beachfront 2015-2016 Fill this portion out if the dancer was not at Beachfront 2015-2016 Were you in another dance program? No Yes YearsPrevious Dance Studio/SchoolNameHow did you hear about us? Newspaper Flyer Signs Television Beachfront Student Name Other Class Enrolled:My child(ren) will be part of the Spring Show.YesNoEmergency Contact InformationContact Name First Last RelationshipHome PhoneWork PhoneMedical ConditionsBallet and other forms of dance are beautiful art forms and are physically demanding. Dance has been compared to football and hockey in the degree of athleticism it requires. Beachfront Dance School uses instruction and training to maintain a student’s fitness. This is a significant factor in reducing injury. Accident and injuries, however, cannot be completely eliminated. Having been informed of this, I affix my signature to this agreement. On behalf of my child, I expressly agree that Beachfront Dance School shall not be liable for any damages arising from personal injury sustained by my child while in classes at its studio or at off-site events sponsored or participated in by Beachfront Dance School. I accept full responsibility for such injuries or damages, which may occur to my child in, on, or about the said premises and activities. Further, with regard to medical treatment, I hereby authorize Beachfront Dance School to act for me in case of emergency. I further agree that Beachfront Dance School shall not be liable for any loss or theft of personal property. I do fully and forever release and discharge Beachfront Dance School and its employees and any other agents, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting form or arising out of my child’s presence on the said premises or involvement in said activities. I understand that Beachfront Dance School may use for publicity and promotional purposes, my child’s name, picture, or a video of her or him participating in its program with no obligations or liability to me. Signature of Parent/GuardianDate Date Format: MM slash DD slash YYYY Product NameTotal $0.00 PhoneThis field is for validation purposes and should be left unchanged.