School of Performing Arts Registration Form
Dancer's First & Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
School *
Your answer
Grade *
Your answer
Parent/Guardian Name *
Your answer
Email *
Your answer
Cell Phone *
Your answer
Emergency Contact *
Your answer
Emergency Contact's Relationship to Student *
Your answer
Emergency Contact's Phone *
Your answer
Medical Info/Health Concerns *
Your answer
Medical Release
In the event you are unable to reach me, in the case of accident or injury, I give my permission for treatment as deemed necessary by staff or emergency personnel. I also release School of Performing Arts (SPA) and its staff of liability in case of injury or accident incurred to:
Child's Name *
Your answer
Parent/Guardian Signature *
(counts as your digital signature)
Your answer
Date *
MM
/
DD
/
YYYY
Submit
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