Student's Name *

First Name

Last Name

Parent's Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Photo Waiver *

I give permission for photos of students in class and at events may be used for promotional purposes (newsletters, brochures, Facebook, website...etc). They will never be sold or used for any other purpose.

Yes

No

Liability Waiver *

I understand and agree that in participating in this workshop there is a possibility of physical injury. I voluntarily agree, therefore, to assume all risks and responsibility for such injury or accident, which might occur to me or my child during any of the First Position classes. I also exempt, release, and indemnify First Position, its owner, assistants, employees, faculty, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss or injury to me, my children, or property which may arise out of our connection with participation in any classes or activities conducted by First Position Dance Company. I further hereby voluntarily agree to waive my rights and that of my children to hold First Position, its owner, agents, volunteers, assistants, employees, faculty owners and members, and/or students liable for such damage, loss, or injury.

I agree

Emergency Contact Name (other than parent) *

In the case we can't get ahold of the student's parents (based off the phone number provided above), please add a secondary person that is close to the student that we can contact in the case of an emergency.

First Name

Last Name

Emergency Contact Phone *

(###)

###

####