Thistle Glen Dancer Registration
Register your dancer
Dancer's name (first, last) *
Your answer
Birth Date *
Your answer
Age *
Your answer
Address *
Your answer
Phone Number and Email Address *
Your answer
Parent's Name(s) *
Your answer
MEDICAL INFORMATION Alberta Health Care No. *
Your answer
Emergency Contact Name & Phone Number: *
Your answer
List of Medications and/or Medical Conditions *
Your answer
Dance Level (Beginner, Premier, etc.)
Your answer
GENERAL RELEASE & WAIVER In consideration of your accepting this registration, I hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I may have against Thistle Glen School of Highland Dance, Edmonton, Alberta, its agents, representatives, owners, employees, successors and assignees, for any and all injuries or illness suffered by me or my child. I have read and agreed to the policies and regulations of Thistle Glen School of Highland Dance, including all fees and payment conditions. Further, in case of any emergency regarding the above registered student, you and/or the emergency contact will be called immediately. If either the parent(s) and/or emergency contact cannot be reached by phone, I authorize any qualified staff member to make any necessary decisions. I further undertake to indemnify Thistle Glen School of Highland Dance, its agents, representatives, owners, employees, successors and assignees, for any claims, however arising, made by me or on behalf of my child. *
Your answer
PHOTO WAIVER: I consent to the use and publication of any photography or likeness of students taken in the course of classes, competitions, workshops, studio events or other activities for the promotional purposes of Thistle Glen School of Highland Dance, including, but not limited to, publication of my likeness and name (or that of my child) on the Thistle Glen School of Highland Dance website/social media. *
Your answer
By adding your name underneath the general wavier and photo release, you have agreed to the terms.
Date of Registration *
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