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All Abilities Praise Dance Workshop Registration
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Email *
Name of Dancer *
Age
Email for communication about workshop *
Emergency Contact Name & Phone Number *
Severe Allergy or Medical Conditions we may need to be aware of:
Please bring a caregiver/helper to stay if needed or desired. This is requested if your dancer is nonverbal, blind, deaf, or has mobility assistance needs such as a wheelchair, walker, etc.
If bringing a caregiver/helper, please state name & relationship to dancer:
Anything else you would like us to know about your dancer?
If you would like to purchase an Open Sky Arts T-shirt to perform in, please choose size and send $15 payment through VENMO here.
*note All-Abilities workshop in memo line with payment
Media Release: I release my & my child(ren)’s photograph and video appearance from this event to be used in the promotional media or website of Open Sky Arts Collective and made available to third-party media outlets (including but not limited to newspapers, magazines, websites) for the purpose of public relations, public information, ministry promotion, publicity, and instruction. *
Required
Emergency Care Release: I hereby release Open Sky Arts Collective and its ministry partners from responsibility and liability for any injury or illness that me or my child may sustain during these activities. In the event of an emergency, I understand that a reasonable effort will be made to contact me. If I cannot be reached, I hereby authorize an agent of Open Sky Arts Collective to act on my behalf to seek emergency medical treatment for myself or my child, in the event that such treatment is deemed necessary by that agent. I authorize the physician selected by said agent to administer such emergency treatment as said physician deems necessary (in his/her judgment) under the circumstances. I understand and agree that I will be responsible for payment of said physician's fee and any and all other fees or expenses associated with such treatment.
*
Required
I understand that by typing my name as guardian of the above dancer constitutes a legal signature for each of the previous selections made in this form. 
Type Guardian signature below:
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A copy of your responses will be emailed to the address you provided.
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