Registration Form 
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Email *
Parent/Guardian Full Name
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Parent/Guardian Phone Number
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Home Address *
Student's Name & Last Name
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Student's Date of Birth
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MM
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DD
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YYYY
Student's Gender
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Emergency Contact Name

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Emergency Contact Phone Number
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Are there any medical conditions, allergies, or special needs your child has that we should know about to ensure their safety and well-being?
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Experience Level
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Location: Elisballet Studio (957 McLean Ave Yonkers NY 10704 - 2nd Floor)

$15 registration fee included 
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Required
Location: Aisling Irish Community Center (990 McLean Ave Yonkers NY 10704 ( Room 1)

$15 registration fee included 
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Required

LIABILITY WAIVER & MAKE-UP CLASS POLICY

I/we understand that participation in dance classes and activities involves physical activity and possible risk of injury. While Elisballet LLC takes precautions to provide a safe environment, accidents may occur.

By agreeing to this form, I/we (the dancer and parent/guardian) assume all risks related to participation in Elisballet LLC classes and activities. I/we release and hold harmless Elisballet LLC, its owner, teachers, staff members, volunteers, and facilities used by Elisballet LLC from any claims, injuries, or damages that may occur before, during, or after classes, except where prohibited by law.

I/we agree to follow all class and facility rules and accept responsibility for any damage caused by the dancer.

If I/we observe any unsafe conditions or conduct, I/we agree to report them to the Owner or Director as soon as possible.

Make-Up Classes:
Missed classes are not refundable; however, students may request a make-up class in another age-appropriate class, based on availability and with Director approval. Make-up classes must be completed within the same season.

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Required
PHOTO/VIDEO RELEASE WAIVER: I acknowledge and consent to allow Elisballet LLC to use: photos and/or videos of my child in publications (such as flyers, our website, or on social media sites). I further understand no financial compensation will be received for the use of these photos/videos.
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Payment Method *
Required
PARENT/GUARDIAN AUTHORIZATION: By Typing my full name below, I confirm that the information provided is accurate and I authorize my child's participation.
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A copy of your responses will be emailed to the address you provided.
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