Tiny Toes Dance Student Registration Form: 2018 - 2019 School Year
Parent and Student Information:
Parent/Guardian Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Email Address *
Your answer
Student First and Last Name *
Your answer
Student Date of Birth (MM/DD/YYYY) *
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DD
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School Name & Class Choice *
Students Classroom/Class Name
Your answer
Release
I/we realize that participation in dance class requires physical movement which could result in personal injury. Although precautions are made, injuries and accidents may happen. By completing registration for Tiny Toes Dance, LLC, I/we acknowledge and assume all risks related to class in the space used.
I/we agree to release and hold harmless Tiny Toes Dance, LLC and (school location), including teachers, dancers, staff members, and facilities used, from any cause of action, claims, or demands now and in the future. I/we will not hold Tiny Toes Dance, LLC and (school location) liable for any personal or property injury and damage that may occur before, during, or after class. In the case that any unsafe conduct or conditions arise, I/we agree to contact Tiny Toes Dance owner and school location director to report concerns as soon as possible.
I give Tiny Toes Dance, LLC permission to use photos taken in class for promotional material online and in print.

Check the box below if you read and understand the release above *
Required
Sign your name for release acknowledgement *
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Date your signature *
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Referred by:
Additional information:
Your answer
Thank you for enrolling in Tiny Toes Dance! Click submit then continue to payment page to finalize your registration.
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