Zumbini Registration

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Thank you for registering you and your child into a Living Arts Dance Studio Zumbini class. We are excited to see you and your children become part of the Living Arts Family!

Please complete this form as we gather important contact information and permissions for our students and their guardians. We use this information for internal communications about Living Arts. We do not sell contact information to 3rd parties.

Upon completion of submitting this form, you will receive an invoice, confirming your registration.

Email Address *

Select what you would like to purchase for this session.

Zumbini Class - 8 week session ($115)

Zumbini Bundle - session book, CD, downloadable music and small plush toy ($35)

Zumbini Downloadable Music Code ($15)

Zumbini large plush character that plays session songs. ($35)

Drop In Class ($15)

Other:

Zumbini Bundle - Session Book, CD, Downloadable Music Code and Plush Toy

Child's First Name *

Child's Last Name *

Child's Age *

Child's Date of Birth *

YYYY

Guardian's First Name *

Guardian's Last Name *

Guardian's Phone # *

Street Address *

City or Township *

Zip Code *

List any health concerns, medications, allergies or accommodations:

I have read completely, understand fully, and agree to the STUDIO POLICIES. (Available at www.livingartsdancestudio.com/general-information) *

I agree

I release Living Arts Dance Studio, it's instructors, independent contractors, and all other associates from liability for harm, theft, or injury that may be suffered by me and/or members of my family traveling to or from or during participation in activities sponsored by Living Arts Dance Studio. *

I agree

I give permission to Living Arts Dance Studio to use pictures and or video of myself or my child for advertising and promotion in print, on social media, our website and on the web. *

Yes

I give permission to Living Arts Dance Studio to communicate with me via email, cell phone, text, and social media platforms. *

Yes

How did you hear about Living Arts? *

Website

Friend

Social Media

Other

Payment Terms: The entire payment is your responsibility and due on or before the first class of the registered session. *

I agree

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