DADS-N-DIVAS - Dual Star Academy of Dance

REGISTRATION FORM
Student's Name*
First Last
Dad's Name*
Dancer's Age*
Account Name*
First Last
Email*
Phone*
Which time do you want to sign up for? If one fills up we will let you know which time is available*
- Sunday, February 15th – 10:30 -11:30 AM (CLASS IS NOW FULL)
- Sunday, February 15th – 12:00 -1:00 PM
Payment Information
Fee: $20/person
Credit Card Authorization*
- I authorize Dual Star Academy of Dance to charge the card on file
Consent*
I agree to the following Medical and Injury Agreement
Medical Agreement
I understand that dancing is a strenuous physical activity. To my knowledge, my child has no medical problems or injuries that would prevent participation in class. I understand that it is my responsibility to inform a physician of any medical issues and to obtain written consent for participation. I agree to inform the instructor(s) of any known health condition that may affect class participation.

Injury Agreement
I agree to release Dual Star Academy of Dance and its participants, or any instructor from liability related to accidents or injury. I also agree to communicate in the event of an injury and understand that physical clearance from a doctor may be required to return to participating in class.

Payment Information