New World Dance - Child Registration
Welcome to New World Dance! Let's get a little information first...
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Student Information
Child First Name *
Child Last Name *
Date of Birth
Prior dance experience (if applicable - we welcome beginners!)
Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last Name
Relationship to child
Email *
Address *
Cell phone number
Additional Parent/Guardian First Name
Additional Parent/Guardian Last Name
Relationship to child
Additional Phone #
What type of dance class(es) are you interested in for your child?
Does your child have any medical conditions we should be aware of?
Liability Release and Waiver - I/we understand that dance training requires sustained, repetitive, vigorous physical activity, usually performed on a hard or lightly padded surface. It is also understood that dance instruction involves kinetic corrections that may include physically touching the student as part of regular class work and rehearsals. I/we understand that there are inherent risk of personal injury and illness arising from my/our child's attendance and participation in such activities and events. I/we hereby agree to release New World Ballet, it's Board of Directors, instructors and agents from all personal injuries, illness or property damage resulting from my/our child's attendance and participation in such activities and events. *
Photo Release - may we take photos and video for the purpose of promoting the school? *
Thank you for submitting your registration form! We look forward to meeting you and your child.
We will call you within 48 hours to answer any questions and set up your first class. You may also call us at 510-332-5250.
You can view the class schedule and pricing information at any time by visiting our website at
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