Dance With Paisley Youth Mover Trial Waiver
Hello and thank you for choosing us. We are so excited to have you try our classes!
We need a bit more info from you to have you dance with us. It will take a couple of minutes.

We will confirm your day and time once you have submitted the form.
Please submit one form per mover trying a class.

See you in class!

Email *
What school does your mover attend? *
What is the name of your mover? What grade are they in? *
Movers birthdate? mm/dd/yyyy *
Movers current age range? *
What song is currently on replay? *
Which location do you prefer?
Clear selection
What Genre of Dance would your mover like to try? ( Ages 13-17 class placement are evaluation based. Studio reserves the right adjust placement at di
Clear selection
What is their favorite color? Current Hobby/Interest outside of dance?
Your First and Last Name *
#1 dream or goal for your child in class? *
Phone number *
Preferred way of contact? *
How did you hear about us? *
Waiver: I hereby authorize the staff of Dance With Paisley and its associates to act, on my behalf, according to their best judgment, in any emergency requiring medical attention, and I hereby waive and release Dance With Paisley and its associates from any and all liability for any injuries or illness incurred while attending virtual and in-person classes. In addition, permission is granted for my child to be photographed/video recorded during Dance With Paisley classes. Permission is also granted that any of these photographs or videos may be used as marketing material to promote Dance With Paisley services. *
Required
An inherent risk of exposure to COVID-19 exists in any public place where people are present. I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by mere presence within this establishment and that such exposure may results in personal injury, illness, or even death. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, program participants, and their families. I hereby release Dance With Paisley from any and all claims arising from or in connection with any direct COVID-19 impact. * *
Required
Anything you'd like to share?
Thank You So Much!
Thank you so much for completing this survey.  It was extremely important for us to connect with you.  We excited to connect like never before and we look forward to seeing you in class!
A copy of your responses will be emailed to the address you provided.
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