Hip Hop Dance Party Registration Form
We are thrilled that you will be joining us for our free Hip Hop Dance Party on January 13, 2018!
Please fill out this short form to be registered.
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Parent Name: *
Email Address: *
Phone: *
Address: *
Street, City, State, Zip
Student Name: *
Student Birthday: *
MM
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DD
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Student Grade: *
Are there any medical conditions or allergies we should know about?
How did you hear about our Hip Hop Dance Party? *
LIABILITY RELEASE:  I understand that injuries are a natural possibility in any athletic endeavor and will assume full responsibility for any injuries incurred at TranscenDance Studios. Therefore, I agree to hold TranscenDance Studios and employees, the host facility and employees, and all organizations associated with and/or in residence at TranscenDance Studios harmless of and from any and all claims, demands, liabilities, losses, lawsuits, judgments, costs, damages, and other expenses of any kind or nature whatsoever. *
Required
PHOTO/VIDEO RELEASE:  I also release the rights to photos and videos taken at TranscenDance Studios functions and agree that TranscenDance Studios and associated organizations may use my image in good taste for promotional purposes. *
Required
RESCUE SQUAD AUTHORIZATION:  I hereby authorize that in the event of a medical emergency a rescue squad may be contacted if TranscenDance Studios Staff deems necessary. *
Required
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