Welcome to DDA Dance Academy's Online Registration for Free Demo/Trial Classes
Child Registration for Free Demo/Trial Class effective 2019
Email address *
Child's Name: *
Your answer
Date of Birth: *
Age: *
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Gender *
Physical Activity Restrictions/Medical Conditions/Allergies *
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Primary Parent(s) or Guardian Name(s): *
Your answer
Primary Parent(s) or Guardian Email(s): *
Your answer
Primary Parent(s) or Guardian Address: *
Your answer
Primary Parent(s) or Guardian Phone Number: *
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Emergency Contact & Phone *
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Parent Agreement
In consideration of the benefits derived from DDA Dance Academy LLC also
referred to as DDA, I (we), my heirs and executors do understand and agree to indemnify and hold harmless,
waive the right to any legal action, release, and discharge Deana M. Gentile, DDA Dance Academy LLC, it’s
directors, agents, servants, employees, and those acting under its authority, from any and all claims at
anytime, and covenant and agree to refrain from suit or any other action for any damages, losses, damages
growing out of injuries to the child or themselves, personal injuries, death, costs occurring to or sustained
by myself, my (our) child while participating (before, during, or after class time) in the dance academy
activities, or while in the act of being transported to and from any activity related to dance, fitness, cheer,
gymnastics and including any and all consequential damage claims which I (we) may be entitled to recover
from said injury or property claim. It is agreed and understood between DDA Dance Academy LLC and the
undersigned for themselves and/or on behalf of their child(s) that anyone participating in a dance academy
activity or event and attending the school/dance/cheerleading program agrees and discloses that they are
carrying their own medical insurance. I/we certify that I and/or my minor child(s)
are physically able to participate in classes and understand there is a risk of bodily injury and other dangers
associated with participation in dance, cheer, acrobatics and fitness activities. I, the undersigned, being the
parent(s) or legal guardia n (s), have read the above damages waiver policy and understand all of its terms. I
execute it voluntarily and with full knowledge of it’s significance.

I further consent to DDA Dance Academy and taking and using photographs and videos of myself and/or child
(s) name, image, interview, performance, or other auditory or visual images indefinitely for commercial
purposes or marketing activities without compensation to my child or me. All photos will be reviewed by
the director, Deana Gentile, prior to being placed on the DDA web site or being used in a video medium.
Parent Agreement *
Any Questions? (contact us here or at 201-819-7989)
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