Windfall Dancers - Online Registration Winter 2017
Please complete a form for each student.

You will have the option to complete your online payment after completing the form.

Dami Lee *
Your answer
Parent's Name [First and Last]
(If student is under 18 years old)
Your answer
Birthday
06/28/1988
Your answer
574-276-7454 *
(xxx) xxx-xxxx
Your answer
Your answer
Contact preferences
Let us know if you'd like to receive Windfall Information via email. You may remove yourself from the mailing list at any time by contacting us.
208 E 2nd St Apt7 *
Street Address
Your answer
Bloomington *
Your answer
Indiana *
Your answer
47401 *
Your answer
Food and/or Medical Allergies
Your answer
Past Injuries
Your answer
Other Important Information
Your answer
Emergency Contact Information
Stephen Shannon *
Your answer
4129991343 *
(xxx) xxx-xxxx
Your answer
friend *
Your answer
Windfall Agreements *
Please read and check "I Agree" [below]. I agree to be responsible for my (or my child's) safety by warming up adequately, not dancing while injured, and by wearing appropriate dancewear during class. I give Windfall permission to seek emergency and medical care on my (or my child's) behalf in the event of a life-threatening situation or injury. I agree I am responsible for my (or my child's) own well-being, and I release Windfall Dancers, Inc. from liability should I (or my child) be injured while here. In return, Windfall promises to take all reasonable precautions to keep students safe.
Required
Registration Agreement *
By registering for a semester of classes, you are committed to fulfilling your payment obligation. If Windfall cancels a class due to low enrollment, you will be entitled to a refund or class credit. Other refunds will only be given with a written doctor's note stating that the student is unable to participate in class, with a $15 administrative fee. Students not able to commit to the entire semester should consider Flexi-Pass or Pay-Per-Class options. By checking "I Agree" [below], I am stating that I have read and understand Windfall's payment and refund policy and that I am responsible for fulfilling my payment obligation.
Required
Dami Lee *
By typing your name in the box below, you understand and agree with the previous statements [Windfall Agreements & Registration Agreement.]If under 18, parent or legal guardian must sign.
Your answer
Photography *
I give Windfall permission to take my (or my child's) photograph for archival and promotional purposes and understand that I will not be compensated for any use of images.
Adult Tap *
Select the class for which you are registering.
Select Class #2 *
Select the class for which you are registering. If you do not want to register for an additional class, please choose N/A.
Select Class #3 *
Select the class for which you are registering. If you do not want to register for an additional class, please choose N/A.
Select Class #4 *
Select the class for which you are registering. If you do not want to register for an additional class, please choose N/A.
Which class length do you want to register?
Notes
Your answer
Online Store
If you are ready to pay for a class then please go to our online store. [The link to the store will appear once you hit "Submit"].
How did you hear about Windfall Dancers? *
Is this your first time at Windfall Dancers?
Submit
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