Jeté Dance Studio, Inc.

Registration Form

Students Name *

Date of Birth *

YYYY

Grade level

Address *

Contact Number *

Email *

Parent/ Guardian Name *

Parent/ Guardian Number *

Emergency Contact Name and Number *

Please List any medical conditions or allergies

Class Registering For *

Class Day *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Time of Class *

Time

Registration Fee and Tuition *

I understand that registration fee and tuition are due to Jete Dance Studio, Inc. at the time of registration. No refunds or credits will be given to classes missed due to any absence. Makeup classes will be an option and must be completed within that same season. Payment must be submitted by cash, check, or credit card at Jete Dance Studio office or through our payment option of Wave.

Required

Liability Waiver *

I understand and agree that with any dance, movement, or exercise class at Jete Dance Studio, Inc., there is the risk of injury or illness. I give consent for my child or myself (if over 18) to participate in the classes and or activities here at Jete Dance Studio, Inc. I take all responsibility and release Jete Dance studio, Inc., the owner, employees, and instructors from all liability if any injury, accident, or illness in contracting Covid-19 that shall occur during any classes or activities.

Required

Medical Emergency Release *

I give Jete Dance Studio, Inc., the owner, and the operators the permission to seek medical treatment in the event of a medical emergency for the participant if the parent or emergency contact cannot be reached. I hereby agree that the participant is in good physical/mental health for the class or activity they are registered for. I have listed any and all medical conditions and allergies.

Required

Photography Waiver *

I allow Jete Dance Studio, Inc. to use all photos and videos of the participant for the sole purpose of promoting and advertising. I give my consent and agree that the participant and parent will not receive any compensation for such that is used for Jete Dance Studio, Inc.

Required

Signature *

I agree everything in this registration is accurate and up to date.

Required

Please sign and date *

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