Wiggle Wednesday Registration
Wiggle Wednesday is a Free dance and story time monthly open to ages 1-5. Children must be accompanies by a grown-up. Waiver form must be filled out below. Limit of 20 families per story time. Children must be supervised by their grown-up at all times.
Child Name: *
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Child Name (additional):
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Child Name (additional)
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Guardian/Parent: *
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Email *
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Address (street, city, state, zip) *
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Date Registering: *
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Release | By signing this contract you agree to release and forever discharge, Tamara Howe School of Dance LLC and their employees from any liabilities growing out of or related to any activities in which I or my child may participate in. I understand that this is a full and complete release for all injuries or damages which I or my child may sustain as a result of my/his/her participation in any activities, regardless of the specific cause thereof. I understand that in the result of any injury, the THSD staff will make every effort to contact me and will seek medical attention for my child if the injury is of serious nature. As the parent or guardian, I am solely responsible for providing insurance coverage in case of injury to my child. I hereby waive all claims for injury, damage or loss of my child or children's person and/or personal property during participation in any Tamara Howe School of Dance LLC class and/or event. I further hold harmless Tamara Howe and THSD agents and employees from any liability for injury, damage or loss which may be caused by any act or omission of any of them. By signing this form, you are also advised that the students will be supervised by the THSD staff or Tamara Howe herself only while in the dance studio. The common areas of the dance studio (i.e. bathrooms, dressing areas, lobby, parking lot, etc) are casually monitored.Electronic Signature Agreement. By selecting the "I Accept" checkbox, I am signing this agreement electronically. I agree this electronic signature is the legal equivalent of my manual signature on this agreement.I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. *
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