Bosses Headquarters Registration Form 3434 Foothill Blvd La crescenta CA 91214
 Please complete this registration form to provide your details for the Headquarters classes. All fields are required to ensure your registration is processed efficiently.
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Monthly Packages NOW available. We are still honoring walk on as well.
How did you hear about Bootscoot Bosses? *
Full Name *
Please provide your first and last name as it appears on your ID.
Address
Enter a valid email address to receive confirmation and further communication.
Email Address *
Enter a valid email address to receive confirmation and further communication.
Phone Number *
Include your country code and number for contact purposes.
MEDICAL ACKNOWLEDGMENT.  Do you have any injuries, medical conditions, or physical limitations that may affect participation?   ☐ No☐ Yes (please explain): _______________________________________________ *
PHOTO & VIDEO RELEASE.   I grant permission to Power Line Dance, LLC / BootScoot Bosses Line Dance Crew to photograph, video record, and use my likeness during classes, rehearsals, and events for promotional, marketing, educational, and social media purposes without compensation.             ☐ I agree.  *
Required
CODE OF CONDUCT.   I agree to conduct myself in a respectful, safe, and responsible manner. I understand that disruptive, unsafe, or inappropriate behavior (including intoxication) may result in removal from class or event without refund. *
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