2 One Productionz Registration
Signing up for classes is simple. Just fill out this online form! Payment is handled in studio.
Email address *
Which Class, Day and Time would you like? *
Required
Student's Full Name *
Your answer
Parent / Guardian's Full Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Email Address *
Your answer
Emergency Contact Full Name *
Your answer
Emergency Contact Phone Number *
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I being a parent or legal guardian of student, a minor hereby grant the permission necessary to allow Minor to participate in the above “2 One Productionz, Inc.” and all activities related. I acknowledge and agree, in my own behalf and on the behalf of the minor, that such participation subjects Minor to possibility of physical illness or injury (minimal, serious, catastrophic, and or death) and that I, in my own behalf and on behalf of the Minor acknowledge that the minor is assuming the risk of such illness or injury by participating in dancing. In the event of such illness or injury, I authorize 2 One Productionz, Inc. to obtain necessary medical treatment for the minor and hereby, in my own behalf and on behalf of the minor, release and hold 2 One Productionz, Inc. Block 26 LLC, and all affiliates of 2 One Productionz, Inc. including Scott Watts the owner, and any representatives in the exercise of authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred on behalf of the minor for any illness or injury that the minor may sustain during participating at 2 One Productionz, Inc. or any 2 One Productionz, Inc. related activity.I, on my own behalf of the minor, further agree to release and hold harmless Releasees from any and all liability for negligence or any other claim, judgment, loss, liability, cost and expenses (including, without limitations, attorney’s fees and costs) arising out of or connected with 2 One Productionz, Inc. including any claim arising out of or connected with any illness or injury that the minor may incur or sustain during participating in all activities associated with 2 One Productionz, Inc. I further expressly agree to indemnify and hold harmless Releasees and Releasee’s heirs, successors, assigns, executors and administrators against loss from any further account of damages of any character resulting to minor in any way from the foregoing activities. I further agree to reimburse and make good to Releases any loss, damages or costs Releasees may have to pay as a result of any action, claim, or demand.I have read and agree that by my child(ren) participating at 2 One Productionz, Inc. and I agree to the Release and Waiver Form. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Flitch Creative. Report Abuse - Terms of Service - Additional Terms