Please register your participant for Motivate By Dance Classes. If you are not registering from a school or organization please go back to www.motivatebydance  and click on the (REGISTER) tab only.
Sign in to Google to save your progress. Learn more
Email *
Which school or organization do you attend? *
Participant Name *
Participant age *
Participant date of birth *
Parent/Guardian name *
Best contact phone number *
PAYMENTS:  $30 EACH MONTH.  Payments are due by the 4th of each month.  A PayPal invoice will be sent to the email address you provided to us.  You can also pay through Cash App $motivatebydance. Classes will be held  in the months of February, March, April and May.  If you wish to pay the full amount of $120 you are welcome to do so.  Pay the Full amount in Cash App or  if using PayPal add a tip" in the invoice and add $90. *
pMOTIVATE BY DANCE, LLC ONLINE MEDIA/PHOTO/VIDEO/WAIVER FORM                                                                             I understand that the above participant may be included in pictures, videos, Facebook, Instagram or other communication forums generated by or to the public. I understand there is no compensation or royalties arising from or related to the use of their image. If the participant is no longer an active member and you wish to opt out of future Motivate By Dance, LLC Media/Video/Photo, please send a letter to   Attention: opt out of  Media/Video/Photo Waiver Form. Please be aware that any public postings before the timestamp of the opt-out email will not be removed. *
MOTIVATE BY DANCE, LLC WAIVER FORM                                                                I agree that the above named participant is in good health and can physically withstand the instruction led by Motivate By Dance, LLC. I hold harmless Motivate By Dance LLC, Coaches, and Volunteers from any injury of any kind that may result from participation of all activities which included meetings, functions or events. I understand that the above participant can be removed at any time due to improper behavior or dress code which includes disobeying rules of the organization or fighting. This waiver has no expiration date. *
Parent or Guardian Name: By typing your first and last name below, I am the legal parent or guardian. I agree to the Motivate By Dance, LLC Waiver Form and the Motivate By Dance, LLC Media/Video/Photo Waiver Form in its entirety.  This agreement has no expiration date. Parent or Guardian please type your first and last name below. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy