Dancers Name *

First Name

Last Name

Parent/ Guardian Name *

First Name

Last Name

1st Emergency Contact Number *

(###)

###

####

2nd Emergency Contact Number

(###)

###

####

Photos *

I agree for my dancer's photo to be taken and allow SGDA to use the images for advertising purposes on posters/brochures/ websites/ social media/ studio notice board.

Yes

No

Participation Waiver *

We require that the dancers PARENT/ GUARDIAN/ reads and agrees to the following waiver: The MEMBER/ PARENT/ GUARDIAN waives and releases Studio G Dance Academy; any program; and it’s employees from any and all claims for personal injury arising during the participation in any program, and/ or while waiting unsupervised before and after class. The MEMBER/ PARENT/ GUARDIAN has read the website/ brochure/ registration details and accepts all policies posted on studiogdanceacademy.com.

Agree

Covid-19 Waiver *

By checking the box the dancers PARENT/ GUARDIAN/ reads and agrees to the COVID-19 waiver. See waiver release form attached at the bottom of the registration form.

Agree

Payment *

I understand the fee of $250 (non-refundable) is to be paid directly to Creative Entity via E-transfer:

Yes