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Six Week Program Registration Form
Please use this form to register to participate in a 6-week session at The Complex. If registering more than one participant, please send separate registrations for each.
Email address *
Participant Name *
Your answer
Phone Number *
Your answer
Which 6-week program are you registering for? *
Your answer
Please indicate any medical conditions here. *
Your answer
In case of emergency, please contact the following person/people. Include names and phone numbers. *
Your answer
I give The Complex permission to seek medical attention for me or my student in case of emergency. I will not hold the studio responsible for injury or for any medical attention sought for said emergency. *
I hereby grant permission to The Complex Performing Arts Centre, Inc. to use photographs and/or video of me or my child/children in publications, news releases, online, and in any other communications related to the mission of The Complex. *
In signing below, I accept my part and agree to pay the non-refundable workshop fee for this session. ($90 for 60 minute classes, $120 for 90 minute classes) *
Please type your name here as your electronic signature agreeing to the contract above. If under 18, please have a parent/guardian sign. *
Your answer
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