Momo Movement 2019 open youth class registration form
Join Momo for a FREE youth class this winter and spring.

These movement classes are for youth with and without disabilities. We encourage youth with disabilities to sign up for a class with a sibling or friend. Age exceptions can be made to partner siblings from different age groups in the same class.

Classes take place at:
Decidedly Jazz Dance Centre
111 12th Ave SE

Classes are split into two age groups:
9 to 12 - 9:15AM to 10:15AM
13 to 17 - 10:30AM to 11:30AM

Classes take place on:
Saturday, February 23
Saturday, March 16
Saturday, April 27

Fees
FREE!

Basic information
Are you new to Momo or a returning dancer? *
Which class date(s) you like to go to? *
Required
Which age group do you belong to?
Dancer information
Dancer's first name *
Your answer
Dancer's last name *
Your answer
Contact phone number *
Your answer
Contact email address (where should we email registration and class information?)
Your answer
Mailing address
Your answer
Will a support person be attending class with the dancer?
Name of support person attending class with dancer.
Your answer
Emergency contact information
First name *
Your answer
Last name *
Your answer
Phone number *
Your answer
Email address *
Your answer
Relationship to dancer
Your answer
Support organization information
This section is optional
Organization name
Your answer
Contact person
Your answer
Phone #
Your answer
Email address
Your answer
Liability waiver
I, as named above, hereby release MoMo Mixed Ability Dance Theatre from any claims, demands and causes of action as a result of my participation or enrolment in the program; participate in all MoMo activities at my own risk; assume all risk involved, including but not limited to all lost or stolen property, cost, claim, injury, damage or liability sustained while participating. *
Required
Photo and video release consent
I, as named above, give permission to MoMo Dance Theatre and media representatives invited by MoMo Dance Theatre, to take photographic and video images of me while I am participating in MoMo Dance Theatre facilitated classes, workshops and performances.I recognize that these images could be used in several ways, including but not limited to: 1. Promote MoMo Dance Theatre 2. Educate people about MoMo Dance Theatre 3. Demonstrate what MoMo Dance Theatre does and is about 4. Include in the portfolio of the photographer/videographer who captured the imagesI retain the right to rescind the permission granted by signing this form at any time. *
Required
Thank you for registering for Momo classes!
Once you hit the submit button at the bottom of the page, your registration form will be complete.

Confirmation and payment emails are sent out once a week on Thursdays.

If your chosen class is full, you will get the next spot on the waiting list and we will let you know!

If you have questions, please contact info@momodancetheatre.org.

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