Trial Class Form
Lindsey Claire Dance Company - 4149 South Siwell Road, Byram, MS 39212
Email address *
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Parent's Name *
Your answer
Address *
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Phone Number *
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Student's Name *
Your answer
Student's Birthday *
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How did you hear about LCDC? *
Your answer
Class Name you would like to Try *
Your answer
Date you will attend class *
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I understand that dance and tumble is a sport. Although rare, injuries sometimes occur. I hereby release the Lindsey Claire Dance Company from any liability for any accident or injury occurring on or around property where my child is enrolled in classes or at any function held at other locations in association with the class in which my child is enrolled. I declare that my child is in good health and is physically able to participate in dance and/or tumble classes. In the event of an injury or emergency when parent or guardian cannot be contacted, I give permission for the Lindsey Claire Dance Company to obtain proper medical attention for my child. *
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A copy of your responses will be emailed to the address you provided.
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