FREE Dance Lesson with Coach Carla
Open to all students new to dance at TPAC!
Email address *
Child's First and Last Name *
Parent's First and Last Name *
Reachable Phone Number *
Dance Styles Interested In (click all that apply) *
Required
How Did You Hear About Us? *
I realize that while TPAC endeavors to take reasonable and appropriate safety precautions, participation in supervised lessons and rehearsals involve some risk of injury. I hereby release and hold harmless TPAC and all of its principals, agents, contractors, and employees of and from any liability, actions, claims, and damages of any kind, on account of injuries of any type or nature incurred in connection with my child’s participation in this program. In case of a medical emergency where I am not immediately available, I authorize TPAC staff to take all actions reasonably necessary to preserve and protect the health of my child. I give my permission for TPAC to attain emergency medical treatment for my child if I cannot be reached. I authorize TPAC to allow my child’s photo to appear in promotional and educational materials without identification. A studio-sanctioned photographer may take photos or videos during classes, rehearsals, and performances for promotional and educational use. For the safety of students, TPAC does not allow any personal videotaping or photography during classes or rehearsals. I understand that TPAC uses social media outlets (such as Facebook and Instagram) that allow for comments and “tagging” by users. *
Thank you! Coach Carla will be in touch within 24 hours.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of SAMM Entertainment.