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Student Information:
Student’s Name and Email are Required Fields

Students Name:
Birthdate:
Address
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Person Responsible for Payment (if different from above):
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Work Number:
Cell Number:
Address:
City:
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Emergency Contact:
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Waiver of Injury: I, the undersigned, do hereby assume full responsibility for any and all damages, injuries or losses that I may sustain or incur, if any, while participating in activities at San Diego Danceworks. I hereby waive all claims against the owners, operators, instructors or other student of San Diego Danceworks for any claim for injuries that I may sustain. I agree to adhere to all tuition and studio policies of San Diego Danceworks as outlined. If under 18, this release and consent is to be signed by the parent or guardian. By selecting this button, this is a digital signature/confirmation of Waiver.