Studio Five Dance Company Online Registration

Registration

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Welcome to Studio Five Dance Company! 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*

Additional Info

Emergency Contact Info*

Contact #1

Contact #1 First Name*

Last Name *

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)

Please click on the Search button below, then choose the class that best suits your child's age as well as your schedule.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Please click on the Search button below, then choose the class that best suits your child's age as well as your schedule.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Please click on the Search button below, then choose the class that best suits your child's age as well as your schedule.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Please click on the Search button below, then choose the class that best suits your child's age as well as your schedule.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Please click on the Search button below, then choose the class that best suits your child's age as well as your schedule.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Waiver and Release of Liability

In consideration of being allowed to participate in any way in any dance instruction, dance rehearsal or dance performance or related events of Studio Five Dance Company LLC ("dance activities"), the guardian hereby acknowledges, appreciates and agrees that there is a risk of injury, including physical injury or death, from the activities involved in the dance activities. The guardian hereby GIVES PERMISSION FOR THEIR SELF/CHILD TO PERFORM DANCE ACTIVITIES including but not limited to complicated dance moves, jumps, stunts, lifts, flips or other gymnastic activities in the studio and in any and all rehearsals and performances. The guardian KNOWINGLY AND FREELY ASSUMES ALL SUCH RISKS, both known and unknown, AND ASSUMES ALL RESPONSIBILITY of my or my child's participation in all the activities of the studio, including all dance activities, EVEN IF ARISING OUT OF THE NEGLIGENCE OF the studio officers, officials, personnel, agents, employees, contractors, assistants, guest artists, volunteers, students, other participants, or owners and lessors of the premises ("the Releasees") and the guardian assumes full responsibility for myself or child's participation. I, for myself and on behalf of my heirs, assigns, representatives and next of kin, HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS Studio Five Dance Company, LLC, their officers, officials, personnel, agents, employees, contractors, assistants, guest artists, volunteers, students, other participants, and owners and lessors of the premises with respect to any and all injury, disability, death or loss or damage to person or property whether arising from the negligence of the Releasees or otherwise to the fullest extent permitted by law. I further certify that I have legal responsibility for any minor child I am registering and have the right to waive these rights. Studio Five Dance Company LLC is not responsible for students who choose not to attend class after being dropped off, or choose to the leave the studio proceeding, during or following a scheduled class. This waiver and release is applicable to any child or other person in the care of the guardian while on the studio property.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.