CDA General Dance Registration
Complete this registration form to enroll for classes and private lessons.
CDA Monday Classes: West Sunset Playground at 39th Avenue/Ortega
CDA Thursday Classes: Temple UMC at 65 Beverly Street/19th Avenue
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Parent's Name (first and last)
Dancer's Name (first and last)
Please check the class(es) below in which your child is enrolling. Age ranges are suggestions; please email
if you need help choosing a class.
Monday Ballet Beg/Ballet I at 4:10 pm (ages 3-7)
Monday Hip Hop Beg/Hip Hop I at 4:10 pm (ages 3-6)
Monday Hip Hop I at 5:00 pm (ages 5 - 8)
Monday Hip Hop II at 5:00 pm (ages 7 - 12)
Private Lesson (Solo)
Private Lesson (Group)
Thursday Ballet Beg/Ballet I at 4:15 pm (ages 3 - 7)
Thursday Ballet II/III at 5:00 pm (ages 7+)
Thursday Hip Hop I at 5:10 pm (ages 5 - 8)
Please check your enrollment option for M/TH classes
Full 7-class Session
Sibling or Multiple Class Discount
Drop-In Class $30
Prorated session (taking the remainder of the session) CDA will email you with an invoice
Child's development, allergies, learning habits, or injuries (please tell us any information that would help us understand and support your child better)
Payment Method (check your email for payment amount).
Venmo: @A-Uyeda (last 4 digits of phone 4790)
Credit Card through Stripe
Liability Waiver and Photo Release
LIABILITY WAIVER: I hereby waive all claims for injury or loss to person or property during participation in classes, workshops or other activities. My participation or my child's participation in this class/workshop is voluntary and at my own risk. To the best of my knowledge, the health information provided is accurate and I acknowledge and fully understand that I or my child will be engaging in activities that involve risk of injury including, but not limited to, pulls or tears (muscles, ligaments or tendons), muscle strains, wrist or foot injuries. I hereby certify that I am or my child is in good health and do not suffer from any heart condition or other ailment that could be exacerbated by the exertion involved in the activities participated in. I agree that I, or my child, will comply with all instructions given to me by the instructor(s) or assigns. I hereby release respective owners, instructors, and assigns from any liability claims, demands, injuries, actions, or causes of actions to my person, my child, or my property arising out of or connected with the use of any of the services, equipment, or facilities provided. I also agree to indemnify the said owners, instructors, agents, and assigns for any claims which are advanced by me or on my behalf, or as a result of any injury to me whatsoever. Further, I confirm that I, or my child, either have specific insurance to cover any injuries sustained, or that I, or my child, have chosen to participate in these activities without any insurance coverage and agree to assume full responsibility of any and all risks, known and unknown, bodily injury, death and property damage which may arise from participation in accepted classes. By signing this form, I agree that I have been informed that I should not participate in any activity if I have any doubt or if I am uncertain as to my current medical condition or my child's current medical condition. I have carefully read with a full, definite and clear understanding the foregoing provisions and freely enter into the within agreement of the Waiver and Indemnification Form. If I am signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights.
PHOTO RELEASE: We at CANVAS Dance Arts love to take photos of students for use on our websites, printouts, social media accounts, and posters. We will be taking photos of students during classes, and you or your child may be in one or more of these photos. Please email
if you DO NOT want your child's image to be shared.
RISK ACKNOWLEDGEMENT REGARDING COVID-19: The collective effort and sacrifice of San Francisco residents staying at home limited the spread of COVID-19. But community transmission of COVID-19 within San Francisco continues, including transmission by individuals who are infected and contagious, but have no symptoms. Infected persons are contagious 48 hours before developing symptoms (“pre-symptomatic”), and many are contagious without ever developing symptoms (“asymptomatic”). Pre-symptomatic and asymptomatic people are likely unaware that they have COVID-19. The availability of childcare, summer camp, Out of School Time (OST) programs, and TK-12 schools is an important step in the resumption of activities. However, the decision by the Health Officer to allow childcare, summer camp, OST programs, and TK-12 schools at facilities that follow required safety rules, does not mean that attending childcare, summer camp, OST programs, and/or TK-12 schools is free of risk. Enrolling a child in childcare, summer camp, OST programs, and/or TK-12 schools could increase the risk of the child becoming infected with COVID-19. While the majority of children that become infected do well, there is still much more to learn about coronavirus in children, including from recent reports of Multisystem Inflammatory Syndrome in Children (MIS-C). Each parent or guardian must determine for themselves if they are willing to take the risk of enrolling their child in childcare, summer camp, OST programs, and TK- 12 schools, including whether they need to take additional precautions to protect the health of their child and others in the household. They should particularly consider the risks to household members who have a higher risk of severe COVID- 19 illness. Parents and guardians may want to discuss these risks and their concerns with their pediatrician or other health care provider. More information about COVID-19 and MIS-C, is available on the Centers for Disease Control and Prevention website at
for a list of groups at higher risk for severe COVID-19 I understand the risks associated with enrolling my child in childcare, summer camp, OST programs, and/or TK-12 schools, and agree to assume the risks to my child and my household. I also agree to follow all safety requirements that the childcare, summer camp, OST programs, and/or TK-12 schools imposes as a condition of enrolling my child.
I have read the waiver, photo release, and risk acknowledgement.
How did you hear about CANVAS Dance Arts?
Ms Simone and Miss Angela
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