Michigan Dance Alliance Online Registration

Registration

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Welcome to Michigan Dance Alliance! Please complete the following registration form.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

City*

Zip*

Additional Info

Emergency Contact Info<br/>(Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

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.

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.

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.

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.

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.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Assumption of Risk

To the best of my knowledge the participating child(ren) in my care, custody and control is in good physical condition and has no disease, physical limitation, health concern or injury that would be aggravated or would be the cause of any injury sustained, before, during or as a result of him or her participating in activities related either directly and/or indirectly to Michigan Dance Alliance, LLC. I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include but are not limited to abnormal blood pressure; fainting; disorders in heartbeat; heart attack; and, in rare instances, death. I recognize that there could be dangers in exercise with regards to dehydration for any child(ren), for whom I am the legal guardian or custodian and for which I have sole responsibilities and duties for their care, custody, control, supervision and wellbeing. I acknowledge that the possibility of certain unusual physical changes as a result of dehydration, including but not limited to abnormal blood pressure; stroke; fainting; disorders in heartbeat; heart attack; and in rare instances, death. I recognize that any minor children under my control, should consume water or other suitable beverages to prevent dehydration and that I am solely responsible for monitoring the conditions and fluid intake of the aforementioned minor child(ren).In any event, I acknowledge and agree that I assume the risks associated with any and all activities and/or physical exercise in which my minor child(ren) participates in. By signing below, I, individually and on behalf of my spouse, do here and forever release and discharge and herby hold harmless Michigan Dance Alliance, LLC, and their respective agents, heirs, executors, administrators, assigns and successors, contractors, officers, directors, members, managers, attorneys and employees from any and all claims, actions, causes of actions, rights, demands, damages, costs, loss of use, loss of service, loss of wages, punitive damages, exemplary damages, medical bills, statutory rights, negligence claims, claims of reckless or willful conduct, expenses and compensation whatsoever, which occur or accrue thereafter arising out of or connected with the participation of myself or the minor children for which I have legal custody or guardianship, in this or any physical activity including any injuries resulting there from.

I've read the above and agree.

Release and Indemnity

I've read the above and agree.

Payment Policy

I've read the above and agree.

COVID Waiver

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*

Registration

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Student #1

Enroll in Classes

Student #2 (Show-Hide Details)

Enroll in Classes

Student #3 (Show-Hide Details)

Enroll in Classes

Student #4 (Show-Hide Details)

Enroll in Classes

Student #5 (Show-Hide Details)

Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies and Agreements

(Show-Hide Details)