DIVAS Mentoring divas Inc. 2019 Registration
Welcome! Please fill out one form per child. Feel free to contact us if you have any questions and/or concerns at 617-861-1256 or DivasMentoringDivas@gmail.com. Each session ends with a recital performance. Costume fees subject to change based on fundraising. Please pay tuition by clicking the registration button on our website. Answer all questions/statements if not applicable be sure to fill in N/A. Class location and confirmed entry will be individually emailed after payment and form have been completed. Costume & Photo payments will be collected during class once info is determined please acknowledge by checking boxes on this form. Thanks
Email address *
Are you a new member? *
Which program is your child/student attending? *
Required
Sessions/Payments (Check all that apply) *
Required
Costumes (TBD based on fundraising) READ & CHECK *
Required
Class Photos (Receive digital photos) *
Required
I/We understand that it is my/our responsibility to bring any special concerns about my/our child/student to the School Director’s attention at the time of registration. I/We understand that D.M.D Inc. reserves the right to dismiss a Student, based on the School Director’s judgment of any/all improper events. If the Student’s behavior interferes with the rights of others, the functioning of the group or activity, or violates the (D.M.D Inc. ) principles of conduct; in such cases, no refunds will be given. *
I/We give permission for my child to be photographed and/ or videotaped and for (D.M.D Inc. ) to use the pictures and videos for publicity purposes. It is understood that (D.M.D Inc. ) will not identify my child/student by name on any website or public production. *
HEALTH WARRANTY: Participant warrants and represents that his/her child/student has no disability, impairment, or ailment that will prevent him/her from engaging in active or passive exercise or that will be detrimental to his/her student’s health, safety, or physical condition if the child/student does engage or participate. If my child/ student has asthma, I agree to provide inhaler everyday and deliver to coach before school starts! *
Please list your child/student's allergies. *
Your answer
My child/student has health coverage either under her parent/guardian or as an individual. *
Required
Physician Name, Number & Hospital: *
Your answer
I'm aware that my child/student needs to bring a pre-filled water bottle to every class. *
Required
I'm aware that my child/student needs to wear black leggings, practice shirt and black sneakers to practice! (Old Members must purchase new shirts if needed) *
Required
I understand that there is a late fee of $1.00 every min after 5 mins for late pick up. (Strictly Enforced) *
Required
Child/Student T-Shirt Size (Include Adult or Youth) *
Your answer
Child/Student Leotard Size (Include Adult or Youth) *
Your answer
How did you hear about our program? *
Required
Contact info
Please enter the following info:
Parent/s Name *
Your answer
Phone number *
Your answer
Childs Name *
Your answer
Childs Age *
Your answer
Childs Grade & School *
Your answer
Questions or Comments
Your answer
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