The Spot Dance Studio Online Registration

Registration

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Welcome to The Spot Dance Studio! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Contact #1

Parent/ Legal Guardian First Name*

Last Name *

Type

How Can We Contact You?

Home Phone *

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

In the event of an emergency,

I authorize the agents of The Spot Dance Studio to administer or use their discretion in securing medical treatment. I understand that every effort will be made to contact (my spouse), the child's parent, guardian, or emergency contact if an emergency occurs. I hereby release The Spot Dance Studio and its teachers from all liabilities for injuries of damages arising out of personal injury of any kind.

I've read the above and agree.

Contact Consent:

The Spot Dance Studio incorporates teaching methods used internationally. There may be times that the teachers may need to touch the child to ensure proper body alignment, turn out, and placement. I give my permission for this instructional contact to be made as part of my training/my child's dance training. I understand that it is my responsibility to observe my child's dance instruction and I will report and concerns immediately.

I've read the above and agree.

Name Usage:

I hereby grant permission for my name/ my child's name to be published in the studio's newsletters or in local newspapers as a result of participating in dance related activities.

I've read the above and agree.

Photo/Video Usage:

I hereby grant permission for me and/or my child to be photographed or videotaped at any dance related events (parades, performances, class activities, etc.). Photographs may be published in the studio's newsletters, in local newspapers, or displayed in the studio. Students (including adults) will be videotaped during the recital and/or other dance related activities.

I've read the above and agree.

By Signature below,

I certify that my minor child is physically able to participate in The Spot Dance Studio of Nampa Idaho's classes and do hereby agree that this business, owners, employers, contractors, assistant teachers are not responsible or liable to me for any personal injury, accident, and/or loss or damage to personal property. I do hereby release this business and its employees,contractors, assistant teachers, owners and agents from any claim or cause of action which may have occurred as a result of my or my minor child's participation in and relinquish all claims I or mu minor child may have against The Spot Dance Studio.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*