Dance Mania - Trial Pass Registration
Welcome to Dance Mania! Thank you for inquiring about our recreational class program.

AS A REMINDER - STUDIO CLOSED THE FOLLOWING DAYS DUE TO END OF YEAR COMPETITIONS & BREAK.

Thursday 4/29
Friday 4/30
Monday 5/3
Wednesday 5/5
Thursday 5/6
Friday 5/7
Monday 5/10 - Friday 5/14 * END OF SEASON BREAK *

This form is only for NEW DANCERS who have not taken a class or created an account with us before. Please do not create a duplicate account if your dancer has or currently is actively enrolled with us.

** Please complete ONE form per family. For liability purposes, only a legal parent / guardian is allowed to complete and sign the form per dancer(s).

If you require login assistance or for website support, please e-mail dancemaniafb@gmail.com
Primary E-Mail Address *
This e-mail address will serve as the username for online system.
Dancer # 1 - Full Name *
Please include first & last name
Dancer # 1 - Date of Birth *
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DD
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YYYY
Dancer # 1 - Age *
As of today
Dancer # 1 - Trial Class *
Please select which class the dancer will be trialing. Any classes not listed below are not eligible for trials.
Dancer # 1 - Trial Class Start Date *
Please specify the date your dancer will be attending their free trial class.
MM
/
DD
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YYYY
Dancer # 2 - Full Name
Please include first & last name
Dancer # 2 - Date of Birth
MM
/
DD
/
YYYY
Dancer # 2 - Age
As of today
Dancer # 2 - Trial Class
Please select which class the dancer will be trialing. Any classes not listed below are not eligible for trials.
Clear selection
Dancer # 2 - Trial Class Start Date
Please specify the date your dancer will be attending their free trial class.
MM
/
DD
/
YYYY
Dancer # 3 - Full Name
Dancer # 3 - Date of Birth
MM
/
DD
/
YYYY
Dancer # 3 - Age
As of today
Dancer # 3 - Trial Class
Please select which class the dancer will be trialing. Any classes not listed below are not eligible for trials.
Clear selection
Dancer # 3 - Trial Class Start Date
Please specify the date your dancer will be attending their free trial class.
MM
/
DD
/
YYYY
Primary Home Address *
Please list street address - i.e. 5678 Dance Mania Lane
City *
State *
Zip Code *
Primary Guardian # 1 Legal Name *
Please list full legal name for parent / guardian of dancer.
Primary Guardian # 1 Contact Number - Cell *
Relationship to Dancer (Guardian #1) *
Please list relationship to dancer.
Would you like to receive e-mails with studio updates and offers? *
Emergency Contact Name *
Please list the full name of an emergency contact who is NOT a parent/guardian.
Emergency Contact Number *
Do any of the dancers listed have previous dance experience? If yes, please describe briefly. *
How did you hear about Dance Mania? *
Dance Mania - Non Member Participation Waiver *
I certify that I am the parent or legal guardian for my child(ren). I understand the nature of this activity and that my child/ren are/is qualified, in good health and in proper physicalcondition to participate in such activity. I acknowledge that if I believe event conditions are unsafe or I am unable to safely perform any activity, I will immediately discontinue participation in the activity. I further acknowledge, understand, appreciate and agree that my child/ren's participation may result in possible exposure to an illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my child/ren's participation and exposure. I further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or ourpresence at the facility. I hereby release, discharge, covenant not to sue and AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS Dance Mania Allstars LLC from all liability, claims, demands, losses or damages on the minor’s or my accountcaused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including,but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I further agree that if,despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above RELEASEES, I WILL DEFEND, INDEMNIFY, AND HOLD HARMLESS each of the RELEASEES from any litigation expenses, attorney fees,loss liability, damage, or cost which any RELEASEE may incur as the result of any such claim. I hereby give my permission for any supervisor, coach or other team administrator associated with the Dance Mania All Stars LLC to seek and give appropriate medical attention for our child(ren) in the event of accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment. I hereby waive, release and forever discharge Dance Mania All Stars LLC and associated supervisor, coach or other team administrator from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Dance Mania All Stars LLC activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my child(ren) is (are) physically fit and capable of participation in all Dance Mania All Stars LLC activities and agree to not hold Dance Mania All Stars LLC responsible for any injury, accident, or incident that may occur while my child(ren) are present in the facility. By registering my child(ren) with the Dance Mania All Stars LLC, I agree to allow my child(ren) to participate in said event hosted by Dance Mania All Stars LLC, and hereby release Dance Mania All Stars LLC, its coaches, staff, and employees from liability for any injury that might occur to my child(ren) while participating in the Dance Mania All Stars LLC program, including travel to and from activity, organization events or other scheduled activities.I agree to indemnify and hold harmless Dance Mania All Stars LLC, their agents and/or employees, against any and all liability for personal injury, including injuries of any kind even resulting in death to me, my child(ren) and/or other family members, or damage to my property, the property to my child(ren) and/or other family members, or both, while I (or my child(ren) or family members) are participating in the Dance Mania All Stars LLC program. I understand that all registrations must be processed through this online portal in order to be eligible for attendance. I understand I have the choice to pay online via credit/debit card or in person using cash or check. I further understand that should I choose to pay online; I will be charged an additional processing fee of 3.0% + $0.30. Should I choose to pay in person, I understand I will not be charged a processing fee. Payment will NOT be accepted without first having completed the online registration portion. I also understand that Dance Mania All Stars LLC reserves the right to cancel or change event schedule at any time for any reason deemed necessary. If course/event that I have paid for is changed or canceled for any reason and there is not an alternate option that fits my needs; I will be eligible for a full or partial refund. If I pay by credit card or ACH (online) I will be refunded the amount of the session or partial session and will not be refunded the processing fee. I will not be charged a refund processing fee if the refund is due to a change brought on directly from Dance Mania All Stars LLC. I understand that if I decide to withdraw at my own will, Dance Mania will decide if I am eligible for a refund. Eligible refunds given for reasons not withstood by Dance Mania All Stars LLC will have the convenience fee subtracted from the amount refunded. I understand that Dance Mania All-Stars LLC produces promotional material about their program. I understand that my child may be included in video tape or photography taken during any activity sponsored by Dance Mania All-Stars LLC which may be published on any social and marketing content owned by Dance Mania All-Stars. I grant Dance Mania All Stars LLC and all other commercial exhibitors the exclusive right to photograph and/or video tape my child and further grant the right to utilize their name, face, likeness, voice, and appearance as part of any sanctioned activity, advertising, or promotion without reservation or limitation. In granting this license, I understand that Dance Mania All-Stars LLC is under no obligation to exercise any of its rights, licenses’, and privileges herein granted.
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