Free Trial Registration

Please complete the form below to register for your FREE TRIAL CLASS.

Your Name Your Name First Last
Participants Name Participants Name First Last
Name of the individual who will participate in the free class.
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Preferred response method

Preferred response method phone email
Class Name
Class Day
Class Date
Class Time
Instructor
I grant permission to the staff of the dance school to take first aid or emergency measures as judged necessary for the care and protection of my child or myself as a parent participating in an organized school activity while under the supervision of the school. In case of medical emergency, I understand that my child/myself will be transported to an appropriate medical facility by the local emergency unit for treatment if the emergency unit deems it necessary. I understand that in some medical situations the staff will need to contact the emergency resource before the child’s parent, physician, and or other person acting on the parent’s behalf. I also understand and agree that the child’s parents or legal guardians shall be responsible for any expenses incurred. As the parent/legal guardian of child named above.
I agree to hold harmless from any and all liability the school, its officers, employees, independent contractors, both in their professional capacity and personally, for all injury or illness resulting from or in any way connected with his/her participation and parents and siblings participation in the classes, activities or special events at the school.

I understand my child’s, or my participation may result in possible exposure to illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. I knowingly and freely assume all such risks, both known and unknown and I will not hold DEDA*, its owners, director, officers, employees, independent contractors, volunteers and any other participants liable for any illness or injury which may result from possible exposure to infectious diseases as a result of participation in any DEDA* class, activity or event offered in a DEDA* studio, other location or on a virtual platform.

I understand that it is the school’s policy that while under the supervision of the school no child is allowed to leave the building without a parent/legal guardian or the written permission of a parent/legal guardian and that the parents/legal guardians assume full responsibility for the actions and behavior of the child, the child's siblings and themselves. Parents/legal guardians give their permission to the school to use photos and or video of their child, child's siblings and themselves without remuneration in connection with school publications, advertising, news and tv coverage.

I understand this is a legal representation of my signature.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
How did you hear about us?

How did you hear about us? Birthday Party at Studio Community Event Parenting Magazine Newspaper Article Newspaper Advertisement Friend Google/Yahoo Facebook Instagram