Dancer Registration Form

First name

Last name

Address

Email address

Phone number

Date of birth

Month

Day

Year

School/Grade

Name of Parent/Guardian (if under 18) Type none if it does not apply.

Emergency Contact Name/ Number

Please list any medical conditions, allergies, injuries, or physical limitations. Type none if it does not apply.

Please list any special accommodations or needs. Type none if it does not apply.

Please provide a description of previous dance experience.

Please click here to view the Liability Waiver, Release and Policy Agreement.

By checking this box, I acknowledge that I have viewed, read and understand the Liability Waiver, Release and Policy Agreement provided by Studio Live Dance Company, LLC.

Please click here to view the required dance attire.

By checking this box, I confirm that I have viewed the dance attire required by Studio Live Dance Company, LLC.

Signature of Dancer or Parent/Guardian (if under 18)

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Date

Registration Fee $175 (Save $25 by registering now!) (Save an additional $25 for renovation delay!)

$125

Please complete one registration form per dance. Contact us for multi-family member discounts.

Dancer Registration Form