Groove With Me- Bring Friend to Class Week Sign Up

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Email *

Record my email address with my response

Name of the GWM Student Inviting You:
*

Class Attending (Day/Time/Instructor)
*

Your Child's Name *

Your Child's Date of birth *

YYYY

Current School they attend
*

Parent/ Guardian Name *

Parent /Guardian Phone Number *

Parent/ Guardian Email *

Emergency contact name and phone number *

Does your child Have Any Allergies or Medical Conditions? Learning differences? Please indicate below.
*

Waiver & Agreement (To Be Signed by Parent/Guardian)
I, the undersigned, understand that my child is voluntarily participating in a dance class at Groove With Me, Inc. I acknowledge that dance is a physical activity and assume all risks associated. I release Groove With Me, its staff, and instructors from any liability for injuries sustained during participation. I confirm my child is in good health and able to participate.

Yes, I acknowledge and agree to the terms above. By checking this box, I provide my electronic signature.

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