Pop-Up Class Registration LinkedInThis field is for validation purposes and should be left unchanged.Dancer's Name(Required)Parent's Name(Required)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email(Required) Home Phone(Required)Cell Phone(Required)Emergency Phone(Required)Grade(Required)Age(Required)DOB(Required) Pop-Up Class I'm Interested InFormer Training(New Students Only)Comments/Questions/NotesHow Did You Hear About Us?FriendsInstagramFacebookAdEvent/performanceOtherIf Other, Please Let Us KnowLiability Statement(Required)Liability/Waiver Statement: I/we realize that participation in dance classes and studio activities could involve personal injury. Despite precautions, accidents and injuries may occur. By signing below this statement, I/we (the student and parent/guardian) assume all risks related to the use of any and all spaces used by Dance Centre North. In addition, I/we agree to hold harmless Dance Centre North and its Director/Faculty and its facilities used, from any cause of action, claims or demands now and in the future. I/we will not hold Dance Centre North and its’ affiliates, liable for any personal injury, personal property damage, theft, or loss, which may occur on the premises before, during, or after classes/rehearsals/performances. I/we hereby assume all financial responsibility for the above registered student. In the event it becomes necessary to refer this account to collections, you (parent/guardian) agree to be held liable for ALL collection fees, including legal fees, interest, etc. I agree to the liability policy.School Policy(Required)I, hereby affirm that I have read and completely understand Dance Centre North’s School Policies, with regard to Attendance, Missed Classes, Promptness, Payments/Fees, School Closings & Changes, Liability Waiver, and will fully comply with the School requirements and Director/Faculty decisions and am registering my child for a pop-up class in the 2026-2027 school year. I agree to Dance Centre North's School PoliciesType your name below to "sign" this form agreeing that all of the above is accurate and agreed.(Required) Δ
