FREE Dance Days at Midwest Dance Center
We're so glad you'll be joining us for Free Dance Days! Please fill out the following form to reserve your child's space. Registration information for regular classes will be available to you, and you'll be able to register for classes at your free class!
Kids can wear dance wear or comfortable clothes and socks to their class.
We recommend arriving 15 minutes early to check in, and take a tour of the facility.
Email address *
Parent First and Last Name *
Your answer
Parent Phone Number *
Your answer
Address *
Your answer
Child First and Last Name *
Your answer
Child Birthdate *
Which Class(es) would your child like to try? (Please base age off of the child's age on Sept 1, 2019) *
How did you hear about free dance days? *
Does your child have any medications, special needs, or allergies that we should be aware of before Free Dance Days? *
Your answer
I understand that Midwest Dance Center, LLC is not responsible for lost items, stolen items, or unclaimed merchandise. I understand that participation in a dance program involves risk and possible injury. I understand that Midwest Dance Center, LLC and its staff will not be held responsible for injuries sustained in class, while performing, or traveling to or from its facilities. I authorize Midwest Dance Center, LLC to secure any emergency treat my child might need. I grand Midwest Dance Center, LLC irrevocable permission to use my child's image and visual likeness in all forms and media for advertising, true, and any other lawful purpose. I agree that all right, title and interest and to all such images and any reproductions or derivative works shall be the exclusive property of Midwest Dance Center, LLC. I agree that Midwest Dance Center, LLC does not owe me any compensation for the acts that I have consented to in this section. I hereby release Midwest Dance Center, LLC from all liability or legal responsibility that may arise from the acts that I have authorized or consented to herein. I have carefully read and understand the terms and conditions of this section. (required) *
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Emily Moorefield.