Register Now :: LA Dance Design

Dancer's Name Required

Date of Birth Required

Parent / Guardian Required

Address Required

City Required

Postal Code Required

Phone # Required

Work #

Cell #

Email Required

Health Card Number Required

Emergency Contact (Name & Phone) Required

Medical Conditions / Concerns

Dance Experience

Class(es) You're Registering For Required

Each applicant and/or their Parent and/or Guardian hereby release L.A. Dance Design Incorporated and its directors, and instructors from claim for personal injury and or illness sustained in, on, or about the facilities and at any other location or function that the applicant might be involved with the studio. Applicants understand that L.A. Dance Design Incorporated is not responsible for lost or stolen items.

I certify that my child is in good health and physical condition which will allow him/her to participate fully in all class activities.

I give consent to L.A. Dance Design to take photographs of the student while participated in school activities and may use such photographs in literature or advertisements for the purpose of promoting L.A. Dance Design. Please specify if there are any media restrictions.

Freedom of Information and Privacy Act: I understand that the information collected on this for is for administrative purposes only.

Once a costume has been ordered I understand that the deposit is non refundable. I am fully aware of the risks and safety precautions in effect to reduce the spread of COVID 19 and I have explained to my dancer proper hand washing/sanitizing techniques as well as social distancing.

I acknowledge that anyone entering the waiting room must wear a protective mask. Once dancers are in the dance studio portion this may be removed.

I understand that due to the nature of dance instruction social distancing cannot always be maintained.

Dancers should remain at home if there are any of these symptoms present – cough, fever, chills, fatigue. All current health requirements as set out by the public health department regarding the current status of covid and its restrictions shall be followed when sending dancers to class.

I have read and understand the above statements and agree to the terms and conditions.

I also understand that communication will be primarily by email and I agree to provide my email address for communication purposes and invoicing purposes.

I understand that classes are subject to change if there are not enough students to run the class. Other options will be provided.

Parent / Guardian Signature Required

Date Required