Child Registration-New World Dance

Child First Name

Child Last Name

Child's Date of Birth

Child's age at time of completing this form

Prior dance experience

What type of dance classes are you interested in for your child?

Parent/Guardian First Name

Parent/Guardian Last Name

Relationship to Child

Adult's Phone Number

Adult's Email

I want to subscribe to the mailing list to stay up to date with class changes and studio events.

Child's Phone Number

Child's email

Address

Additional Parent/Guardian First Name

Additional Parent/Guardian Last Name

Additional Parent/Guardian Phone Number

Additional Parent/Guardian Relationship to child

Does your child have any medical conditions we should be aware of?

Photo Release - may we take photos and video for the purpose of promoting the school? Please note that we do not allow photos and videos to be taken by other students or parents during class without prior permission.

Liability Release and Waiver

I/we understand that dance training requires sustained, repetitive, vigorous physical activity, usually performed on a hard or lightly padded surface. It is also understood that dance instruction involves kinetic corrections that may include physically touching the student as part of regular class work and rehearsals. I/we understand that there are inherent risk of personal injury and illness arising from my/our child's attendance and participation in such activities and events. I/we hereby agree to release New World Ballet, it's Board of Directors, instructors and agents from all personal injuries, illness or property damage resulting from my/our child's attendance and participation in such activities and events.

By signing below, I/we acknowledge that I/we have carefully read this agreement; I/we understand it is a full release of liability and agree to be bound thereby.

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