2025

BPA ENROLMENT

Parent First Name *

Parent Last Name *

Street Address

City

State

Country

Postal code

Phone *

Email *

Student 1 First Name

Student 1 Last Name

Student 1 Date of Birth

Student 1 CHOOSE YOUR AGE GROUP

Student 2 First Name

Student 2 Last Name

Student 2 Date of Birth

CHOOSE YOUR AGE GROUP

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

Liability Release: I acknowledge and understand the nature of physical activities, I understand accidents and/or physical injury may occur. I acknowledge that I could come into contact with germs and bacteria at dance class. I agree to participate at my own risk. I agree to release and hold harmless all parties involved, including any and all staff members from any cause of action, claims, or demands now and in the future. I will not hold this studio as a whole or its staff liable for any personal injury, catastrophic injury or any personal property damage or loss, which may occur on the premises before, during or after classes.

Clear

I consent for photos and videos are allowed to be taken of my child. I also allow media and promotional use of my child's photos and videos.

Please sign below.

Signature

Clear