walla walla DANCE company

Student Name *

First Name

Last Name

Date of Birth *

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DD

YYYY

Parent/Guardian's Name *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

First Name

Last Name

Emergency Contact Phone *

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LIABILITY RELEASE: *

I acknowledge that dance is a physical art form and there is a possibility of injury. Although, the staff are trained teachers, I understand that my daughter/son is assuming the risk of such injury and I release The Walla Walla Dance Company, and their instructors/coaches from any claim for injuries sustained under their supervision. In the event that I am not present and unable to be reached, I authorize The Walla Walla Dance Company staff to seek medical attention in case of emergency. By submitting this online form, I acknowledge that I have read, understand any assumed risks and will abide by the tuition polices of The Walla Walla Dance Company.

Yes, I agree.

No, I don't agree.

July 22 - July 25

M - Th | 11am - noon | ages 7 - 10 | HIP HOP & JAZZ

M - Th | 12pm - 1 pm | ages 12 - 18 | LYRICAL, HIP HOP & JAZZ

July 29 - August 1

M - Th | 11am- noon | level 2 & up LYRICAL, HIP HOP & JAZZ