Name *

First Name

Last Name

What class are you participating in?

Heels Class

Jesus Take the Wheels

Technique

Twirling

Tumbling

Stretch and Release

Studio Policy

I have read, understand, and agree to adhere to each of the policies set forth by Tanika Dean Dance Company. I acknowledge that I have read, understand and agree to these policies and procedures.

Yes

No

Waiver of Liability

I recognize and understand the risks of physical injury inherent to dance and tumbling training and I fully assume those risks. I hereby release Tanika Dean Dance Company, its affiliates dance studios, event sponsors, employees and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes, rehearsals, workshops, or performances. I agree to indemnify, defend, and hold harmless Tanika Dean Dance Company., its affiliate dance studios, event sponsors, employees and dance teachers for liabilities, costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage to any person or property.

Yes

No

Medical Attention Policy

In case of physical injury or medical emergency, I hereby authorize Tanika Dean Dance Company, to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergencies, or if my child is under 18, I understand that Tanika Dean Dance Company will attempt to notify the person(s) I have named on my student information sheet as my emergency contact(s) of my condition and how to reach me.

Yes

No