2019-20 Adult Programme Registration
First Name *
Last Name *
Email *
Phone Number *
Health Issues? *
Birthday *
MM
/
DD
/
YYYY
Emergency Contact Name *
Emergency Contact Number *
(All contact information will be kept confidential)
How did you find out about the studio? *
Can we send you email updates to keep you informed on what's happening at the studio? *
Do you approve the use of class and performance photographs/videos of you for our website, social media, and/or promotional material? *
ADULT PROGRAM WAIVER
Please read carefully:
• Students may post videos or photographs of themselves on the internet but not without the approval of other students in
the videos or photographs.
• A $25 fee will be charged on all NSF cheques.
• Class Passes are non-transferable and non refundable. Five or Ten Class passes are valid for 6 months from first use;
Monthly Passes are valid for 30 days from first use. Monthly passes cannot be used for day-time classes.
• The studio may cancel classes due to inclement weather or other reasons beyond their control.
• I hereby absolve Dance Fusion Studios and its instructors from any responsibility regarding injury incurred and will not
hold Dance Fusion Studios liable for lost articles.
Signature *
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