Contact Improv Workshop Registration
Please complete the form fully, submit and pay using the PayPal button below.
Participant Last Name *
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Participant First Name *
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Email Address *
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Do you authorize Guelph Dance to add your email to our mailing list? We send monthly newsletters using Mailchimp. *
Parent/Guardian (If Under 18)
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Telephone of Parent/Guardian
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Emergency Contact Name and Phone Number *
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I authorize that photos taken of the participant by GD may be used for future GD promotions. *
By submitting this form, I am authorizing the above named participant to take part in the Guelph Dance Contact Improv Workshop with Mark Young. In the case of injury or accident of any kind at the Workshop, neither Guelph Dance (GD) or Guelph Youth Dance Studios nor any employee, nor volunteer of GD, or the GYDS will be held liable for the occurrence. I hereby release GD, and GYDS, its employees or volunteers from all claims or damage, which may arise out of any loss or personal injury to the named participant in this program. ADD INITIALS IF YOU ARE IN AGREEMENT *
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